Glucose Metabolism DisordersATGDNCT02994459
Study of Fat Tissue's Ability to Take up Sugar in the Obese Population
An observational study of Glucose Metabolism Disorders, run by University of Missouri-Columbia at 1 site in United States.
Trial summary
People who are obese often have insulin resistance (inability of insulin to properly control blood sugar) and high blood sugar. However, not all people with obesity have this problem. About one-third of people with obesity have normal sugar metabolism (the way your body uses sugar). Read more about this study
- Who is it for?
- Ages 18 to 64 yearsHealthy volunteers can take part
- Conditions the study is for
- Glucose Metabolism Disorders
- What is being tested?
- Weight Loss
- Type of treatment
- Injection or infusion
- How many people
- 90 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Jul 2017to Jan 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 64 years
- All sexes
- Healthy volunteers accepted
- Adult
Study population: The investigators plan to study a total of 45 men and women of all races and ethnic groups: 15 MAO (metabolically abnormal obese, likely insulin resistant), 15 MNO (metabolically normal obese, likely insulin sensitive), and 15 lean. All three groups will be balanced with regards to sex and race/ethnicity distribution, and the two obese groups will also be matched on percent total body fat. They will also attempt to recruit 15 metabolically abnormal lean participants.
Who may be able to join
- All subjects
- Age: greater than or equal to 18 years but <65 years
- Weight stable (i.e., ±2 kg for at least 3 months)
- Sedentary (less than 1 hour of structured exercise per week)
- No evidence of significant organ system dysfunction or disease (e.g., diabetes, impaired kidney function, cancer, etc.)
- In addition, subjects must fulfill all of the following inclusion criteria.
Show all 23Show fewer
- Metabolically Normal Lean
- BMI greater than or equal to 18.5 but <25.0 kg/m2
- Fasting blood glucose: <100 mg/dl
- Blood glucose 2 h after an OGTT: <140 mg/dl
- HbA1c <5.7 %.
- Metabolically Normal Obese, likely insulin sensitive
- BMI greater than or equal to 30.0 but <45.0 kg/m2
- Fasting blood glucose: <100 mg/dl
- Fasting insulin: <20 mU/l
- Blood glucose 2 h after an OGTT: <140 mg/dl
- HbA1c <5.7 %.
- Metabolically Abnormal Obese, likely insulin resistant
- BMI greater than or equal to 30.0 but <45.0 kg/m2
- Fasting blood glucose ≥100 mg/dl or blood glucose 2 h after an OGTT ≥140 mg/dl or fasting insulin >20 µU/mL or HbA1c >5.7 %.
- Metabolically Abnormal Lean
- BMI greater than or equal to 18.5 but <25.0 kg/m2
- Fasting blood glucose ≥100 mg/dl or blood glucose 2 h after an OGTT ≥140 mg/dl or fasting insulin >20 µU/mL or HbA1c >5.7 %.
Who cannot join
None listed.
Trial locations and contacts
1 site in 1 country.
United States1 site
Washington University School of Medicine
St Louis, Missouri, 63110
About this study
Official title: Adipose Tissue Glucose Uptake in Obesity (ATGD)
People who are obese often have insulin resistance (inability of insulin to properly control blood sugar) and high blood sugar. However, not all people with obesity have this problem. About one-third of people with obesity have normal sugar metabolism (the way your body uses sugar). Similarly, not all people who are lean are also metabolically healthy and a subset of people who are lean are referred to as metabolically abnormal lean (MAL) or metabolically obese lean because they have the abnormalities in glucose metabolism typically associated with obesity. The reasons why some people with obesity have a problem with blood sugar control and others do not are not entirely clear. It is thought that impaired muscle sugar uptake is the main problem related to high blood sugar in people with obesity. However, adipose tissue (fat tissue) also consumes a substantial amount of blood sugar. Therefore, it is unclear whether muscle or adipose tissue (fat tissue) are primarily responsible for altered blood sugar concentrations in persons with metabolically abnormal obesity (MAO) (those with insulin resistance), compared to those with metabolically normal (healthy) obesity (MNO), or whether "healthy" adipose tissue (fat tissue) expansion in MNO people compared with lean people provides a vessel for blood sugar removal that helps maintain normal blood sugar concentration.
Accordingly, the investigators will determine the amount of sugar that is taken up by the body and in the cells of adipose tissue (fat tissue) and muscle by infusing labeled sugar into the blood and looking at its disappearance from blood and appearance in adipose tissue (fat tissue) and muscle. The investigators will also determine how well insulin, a hormone that controls blood sugar, turns on signals that stimulate sugar uptake in fat and muscle cells. These studies will be done after an overnight fast and during an infusion of sugar and insulin (hyperinsulinemic-euglycemic clamp), in sex- and age-matched people who are insulin resistant and insulin sensitive. People with obesity will also be invited to complete a ~10% diet-induced weight loss program and will be studied again after they have achieved the weight loss goal. A group of sex- and age-matched metabolically normal lean participants will serve as control group. An attempt will be made to also study a group of sex- and age-matched metabolically abnormal lean participants.
- Conditions
- Glucose Metabolism Disorders
- Being tested
- Weight Loss
- Medical subject headings
- Glucose Metabolism Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Weight LossOther
Diet-induced weight loss (obese only)
| Study group | Role | What they receive |
|---|---|---|
| Metabolically Normal Obese (likely insulin sensitive) | i) BMI ≥30.0 but <45.0 kg/m2; maximum body circumference <165 cm to ensure subjects fit into the PET/CT and MR scanners; iii) fasting blood glucose: <100 mg/dl; iv) blood glucose 2 h after an OGTT: <140 mg/dl; v) HbA1c <5.7 %; vi) fasting insulin: <20 µU/mL. Receives: Other: Weight Loss | |
| Metabolically Abnormal Obese (likely insulin resistant) | i) BMI ≥30.0 but <45.0 kg/m2; maximum body circumference <165 cm to ensure subjects fit into the PET/CT and MR scanners; iii) fasting blood glucose: ≥100 mg/dl or blood glucose 2 h after an OGTT: ≥140 or fasting insulin: >20 µU/mL. Receives: Other: Weight Loss | |
| Metabolically Normal Lean | i) BMI ≥18.5 but <25.0 kg/m2; ii) maximum body circumference <165 cm to ensure subjects fit into the PET/CT and MR scanners; iii) fasting blood glucose: <100 mg/dl; iv) blood glucose 2 h after an OGTT: <140 mg/dl; v) HbA1c <5.7 %; vi) fasting insulin: <20 µU/mL. | |
| Metabolically Abnormal Lean | i) BMI ≥18.5 but <25.0 kg/m2; ii) maximum body circumference <165 cm to ensure subjects fit into the PET/CT and MR scanners; iii) iii) fasting blood glucose: ≥100 mg/dl or blood glucose 2 h after an OGTT: ≥140 or fasting insulin: >20 µU/mL. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Contribution of subcutaneous adipose tissue glucose uptake to whole-body glucose disposal in people who are insulin sensitive or insulin resistant (defined as insulin-mediated glucose disposal rate)
Comparison of whole body and total adipose tissue glucose disposal rate assessed by using stable isotope labeled glucose tracer infusion in conjunction with dynamic PET imaging
Measured: Baseline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Dec 2016 (estimated)
- Study start1 Jul 2017
- Primary completionJan 2027 (estimated)
- Study completionJan 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Glucose Metabolism DisordersStudies of the same condition, open and under way.
- More trials run by University of Missouri-ColumbiaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Cross-sectional
- Enrolment
- 90 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Missouri-Columbia
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Bettina Mittendorfer, University of Missouri-Columbia
- Investigators
- Bettina Mittendorfer, PhD, Principal investigator, Washington University School of Medicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02994459
- Sponsor's protocol ID
- 201610005
- Acronym
- ATGD
- Status last verified
- Apr 2026
- First submitted
- 9 Dec 2016
- Last updated
- 8 May 2026
- Results posted
- No
- Data monitoring committee
- Yes
- Individual data sharing
- Yes: The investigators do not currently anticipate to share IPD, but will do so upon request.
Publications
Cao C, Koh HE, Van Vliet S, Patterson BW, Reeds DN, Laforest R, Gropler RJ, Mittendorfer B. Increased plasma fatty acid clearance, not fatty acid concentration, is associated with muscle insulin resistance in people with obesity. Metabolism. 2022 Jul;132:155216. doi: 10.1016/j.metabol.2022.155216. Epub 2022 May 13.
PubMed 35577100van Vliet S, Koh HE, Patterson BW, Yoshino M, LaForest R, Gropler RJ, Klein S, Mittendorfer B. Obesity Is Associated With Increased Basal and Postprandial beta-Cell Insulin Secretion Even in the Absence of Insulin Resistance. Diabetes. 2020 Oct;69(10):2112-2119. doi: 10.2337/db20-0377. Epub 2020 Jul 10.
PubMed 32651241
Study at a glance
From the registry record, last updated by the sponsor on 8 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Adipose Tissue Glucose Uptake in Obesity (ATGD)
- ClinicalTrials.gov ID
- NCT02994459
- Acronym / sponsor ID
- ATGD / 201610005
- Conditions
- Glucose Metabolism Disorders
- Study type
- Observational
- Recruitment status
- Active, not recruiting
- Enrolment
- 90 participants (estimated)
- Lead sponsor
- University of Missouri-ColumbiaUniversity, hospital or other
- Study start
- 1 Jul 2017 (actual)
- Primary completion
- Jan 2027 (estimated)
- Study completion
- Jan 2027 (estimated)
- First posted
- 15 Dec 2016 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
People who are obese often have insulin resistance (inability of insulin to properly control blood sugar) and high blood sugar. However, not all people with obesity have this problem. About one-third of people with obesity have normal sugar metabolism (the way your body uses sugar). Similarly, not all people who are lean are also metabolically healthy and a subset of people who are lean are referred to as metabolically abnormal lean (MAL) or metabolically obese lean because they have the abnormalities in glucose metabolism typically associated with obesity. The reasons why some people with obesity have a problem with blood sugar control and others do not are not entirely clear. It is thought that impaired muscle sugar uptake is the main problem related to high blood sugar in people with obesity. However, adipose tissue (fat tissue) also consumes a substantial amount of blood sugar. Therefore, it is unclear whether muscle or adipose tissue (fat tissue) are primarily responsible for altered blood sugar concentrations in persons with metabolically abnormal obesity (MAO) (those with insulin resistance), compared to those with metabolically normal (healthy) obesity (MNO), or whether "healthy" adipose tissue (fat tissue) expansion in MNO people compared with lean people provides a vessel for blood sugar removal that helps maintain normal blood sugar concentration.
Accordingly, the investigators will determine the amount of sugar that is taken up by the body and in the cells of adipose tissue (fat tissue) and muscle by infusing labeled sugar into the blood and looking at its disappearance from blood and appearance in adipose tissue (fat tissue) and muscle. The investigators will also determine how well insulin, a hormone that controls blood sugar, turns on signals that stimulate sugar uptake in fat and muscle cells. These studies will be done after an overnight fast and during an infusion of sugar and insulin (hyperinsulinemic-euglycemic clamp), in sex- and age-matched people who are insulin resistant and insulin sensitive. People with obesity will also be invited to complete a ~10% diet-induced weight loss program and will be studied again after they have achieved the weight loss goal. A group of sex- and age-matched metabolically normal lean participants will serve as control group. An attempt will be made to also study a group of sex- and age-matched metabolically abnormal lean participants.
Study design
- Observational model
- Cohort
- Time perspective
- Cross-sectional
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Metabolically Normal Obese (likely insulin sensitive) | – | Other: Weight Lossi) BMI ≥30.0 but <45.0 kg/m2; maximum body circumference <165 cm to ensure subjects fit into the PET/CT and MR scanners; iii) fasting blood glucose: <100 mg/dl; iv) blood glucose 2 h after an OGTT: <140 mg/dl; v) HbA1c <5.7 %; vi) fasting insulin: <20 µU/mL. |
| Metabolically Abnormal Obese (likely insulin resistant) | – | Other: Weight Lossi) BMI ≥30.0 but <45.0 kg/m2; maximum body circumference <165 cm to ensure subjects fit into the PET/CT and MR scanners; iii) fasting blood glucose: ≥100 mg/dl or blood glucose 2 h after an OGTT: ≥140 or fasting insulin: >20 µU/mL. |
| Metabolically Normal Lean | – | –i) BMI ≥18.5 but <25.0 kg/m2; ii) maximum body circumference <165 cm to ensure subjects fit into the PET/CT and MR scanners; iii) fasting blood glucose: <100 mg/dl; iv) blood glucose 2 h after an OGTT: <140 mg/dl; v) HbA1c <5.7 %; vi) fasting insulin: <20 µU/mL. |
| Metabolically Abnormal Lean | – | –i) BMI ≥18.5 but <25.0 kg/m2; ii) maximum body circumference <165 cm to ensure subjects fit into the PET/CT and MR scanners; iii) iii) fasting blood glucose: ≥100 mg/dl or blood glucose 2 h after an OGTT: ≥140 or fasting insulin: >20 µU/mL. |
Who may qualify
- Ages
- 18 to 64 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
- Study population
- The investigators plan to study a total of 45 men and women of all races and ethnic groups: 15 MAO (metabolically abnormal obese, likely insulin resistant), 15 MNO (metabolically normal obese, likely insulin sensitive), and 15 lean. All three groups will be balanced with regards to sex and race/ethnicity distribution, and the two obese groups will also be matched on percent total body fat. They will also attempt to recruit 15 metabolically abnormal lean participants.
Key inclusion criteria (23 listed)
- All subjects
- Age: greater than or equal to 18 years but <65 years
- Weight stable (i.e., ±2 kg for at least 3 months)
- Sedentary (less than 1 hour of structured exercise per week)
- No evidence of significant organ system dysfunction or disease (e.g., diabetes, impaired kidney function, cancer, etc.)
Key exclusion criteria (0 listed)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Weight LossDiet-induced weight loss (obese only) | Other | Metabolically Abnormal Obese (likely insulin resistant), Metabolically Normal Obese (likely insulin sensitive) |
Primary outcome
Contribution of subcutaneous adipose tissue glucose uptake to whole-body glucose disposal in people who are insulin sensitive or insulin resistant (defined as insulin-mediated glucose disposal rate)
Time frame: Baseline
Comparison of whole body and total adipose tissue glucose disposal rate assessed by using stable isotope labeled glucose tracer infusion in conjunction with dynamic PET imaging
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 May 2026.
- Derived from this study: PubMed 35577100Cao C, Koh HE, Van Vliet S, Patterson BW, Reeds DN, Laforest R, Gropler RJ, Mittendorfer B. Increased plasma fatty acid clearance, not fatty acid concentration, is associated with muscle insulin resistance in people with obesity. Metabolism. 2022 Jul;132:155216. doi: 10.1016/j.metabol.2022.155216. Epub 2022 May 13.
- Derived from this study: PubMed 32651241van Vliet S, Koh HE, Patterson BW, Yoshino M, LaForest R, Gropler RJ, Klein S, Mittendorfer B. Obesity Is Associated With Increased Basal and Postprandial beta-Cell Insulin Secretion Even in the Absence of Insulin Resistance. Diabetes. 2020 Oct;69(10):2112-2119. doi: 10.2337/db20-0377. Epub 2020 Jul 10.
- Individual participant dataSharing planned: Yes. The investigators do not currently anticipate to share IPD, but will do so upon request.
Related trials for Glucose Metabolism Disorders
Not yet recruitingPhase 3
Efficacy and Safety of Once-Weekly SHR-3167 Compared With Once-Daily Insulin Glargine in Adults With Insulin-Naive Type 2 Diabetes
Type 2 Diabetes
Recruiting
Effects of Lean Pork Loin Intake on Protein Homeostasis and Glucose Regulation in Prediabetic Adults
Hyperglycaemia (Non Diabetic), Prediabetes
Recruiting
Investigating Vascular Properties of HEMI and SPG Signals in Individuals With or at Risk for Chronic Kidney Disease
Chronic Kidney Disease, Hypertension (HTN)
Active, not recruiting
Effect of Probiotics on Insulin Sensitivity in Overweight and Obese Pregnancy
Obesity & Overweight, Gestational Diabetes Mellitus (GDM)
Not yet recruitingPhase 3
A Study to Evaluate the Effectiveness and Safety of the Drug AZD6234 for Managing Weight in Adults Who Are Obese or Overweight. These Participants May or May Not Also Have Type 2 Diabetes
Obesity, Overweight
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Bettina Mittendorfer, PhD principal investigator
Washington University School of Medicine
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Glucose Metabolism Disorders, run by University of Missouri-Columbia at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 23 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 8 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Contribution of subcutaneous adipose tissue glucose uptake to whole-body glucose disposal in people who are insulin sensitive or insulin resistant (defined as insulin-mediated glucose disposal rate) (time frame: Baseline). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02994459, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 May 2026.