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Type 2 Diabetes MellitusNCT03323827

MOLECULAR REGULATION OF MUSCLE GLUCOSE METABOLISM (AIMS 2A, 2B, 3)

An observational study of Type 2 Diabetes Mellitus and Obesity, run by University of Arizona at 1 site in United States.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The molecular nature of insulin resistance in human muscle is still incompletely defined. Our data indicate that acetylation of mitochondrial proteins in humans is regulated by muscle contraction and is dysregulated in insulin resistance. Read more about this study

Who is it for?
Ages 21 to 65 years
Conditions the study is for
Type 2 Diabetes Mellitus, Obesity
How many people
72 participants
Where
1 siteUnited States
Study dates
Nov 2016to Aug 2018
Phase
Observational
Are there results?
None posted in the registry

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 21 to 65 years
  • All sexes
  • Adult, Older adult

Study population: The study population is described here with respect to the three aims of this project. Specific Aim 2. To determine how the cytosolic and mitochondrial protein acetylomes are regulated by muscle contraction in insulin sensitive and resistant human volunteers. Aim 2a. Subjects. Two groups (aged 21-65) will be studied: lean (BMI<25), healthy insulin sensitive subjects, and obese (BMI>30) nondiabetics 20 subjects will be enrolled Aim 2b (muscle contraction and acetylation). Subjects. Two groups (aged 21-65) will be studied: lean (BMI<25), healthy insulin sensitive subjects, and obese (BMI>30) 32 subjects will be enrolled Specific Aim 3. To determine how acetylation of the mitochondrial inner membrane adenine nucleotide translocase ANT1 regulates protein structure and function. Subjects. Two groups (aged 21-65) will be studied: lean (BMI<25), healthy insulin sensitive subjects, and obese (BMI>30) 20 subjects will be enrolled.

Who may be able to join

  • Aim 2a. Subjects. Two groups (aged 21-65) will be studied: lean (BMI<25), healthy insulin sensitive subjects, and obese (BMI>30) nondiabetics 20 subjects will be enrolled
  • Subjects must be able to communicate meaningfully with the investigator and must be legally competent to provide written informed consent.
  • Subjects may be of either sex with age as described in each protocol. Female subjects must be non-lactating and will be eligible only if they have a negative pregnancy test throughout the study period.
  • Subjects must range in age as described in each specific protocol.
  • Subjects must have the following laboratory values:
  • Hematocrit ≥ 35 vol% Serum creatinine ≤ 1.6 mg/dl AST (SGOT) < 2 times upper limit of normal ALT (SGPT) < 2 times upper limit of normal Alkaline phosphatase < 2 times upper limit of normal Triglycerides < 150 mg/dl. PT 11.7 -14.3 (During Liposyn/heparin infusion, PT will be determined to insure that it is < 1.5-2.0 times the normal value.) PTT 23.0-37.0.
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  • Aim 2b (muscle contraction and acetylation). Subjects. Two groups (aged 21-65) will be studied: lean (BMI<25), healthy insulin sensitive subjects, and obese (BMI>30) 32 subjects will be enrolled
  • Subjects must be able to communicate meaningfully with the investigator and must be legally competent to provide written informed consent.
  • Subjects may be of either sex with age as described in each protocol. Female subjects must be non-lactating and will be eligible only if they have a negative pregnancy test throughout the study period.
  • Subjects must range in age as described in each specific protocol.
  • Subjects must have the following laboratory values:
  • Hematocrit ≥ 35 vol% Serum creatinine ≤ 1.6 mg/dl AST (SGOT) < 2 times upper limit of normal ALT (SGPT) < 2 times upper limit of normal Alkaline phosphatase < 2 times upper limit of normal Triglycerides < 150 mg/dl. PT 11.7 -14.3 (During Liposyn/heparin infusion, PT will be determined to insure that it is < 1.5-2.0 times the normal value.) PTT 23.0-37.0.
  • Aim 3 Subjects. Two groups (aged 21-65) will be studied: lean (BMI<25), healthy insulin sensitive subjects, and obese (BMI>30) 20 subjects will be enrolled.
  • Subjects must be able to communicate meaningfully with the investigator and must be legally competent to provide written informed consent.
  • Subjects may be of either sex with age as described in each protocol. Female subjects must be non-lactating and will be eligible only if they have a negative pregnancy test throughout the study period.
  • Subjects must range in age as described in each specific protocol.
  • Subjects must have the following laboratory values:
  • Hematocrit ≥ 35 vol% Serum creatinine ≤ 1.6 mg/dl AST (SGOT) < 2 times upper limit of normal ALT (SGPT) < 2 times upper limit of normal Alkaline phosphatase < 2 times upper limit of normal Triglycerides < 150 mg/dl. INR < 1.3

Who cannot join

  • Aim 2a
  • Subjects must not be receiving any of the following medications: thiazide or furosemide diuretics, beta-blockers, or other chronic medications with known adverse effects on glucose tolerance levels unless the patient has been on a stable dose of such agents for the past three months before entry into the study. Subjects may be taking a stable dose of estrogens or other hormonal replacement therapy, if the subject has been on these agents for the prior three months. Subjects taking systemic glucocorticoids are excluded.
  • Subjects with a history of clinically significant heart disease (New York Heart Classification greater than grade II; more than non-specific ST-T wave changes on the EKG), peripheral vascular disease (history of claudication), or pulmonary disease (dyspnea on exertion of one flight or less; abnormal breath sounds on auscultation) will not be studied.
  • Recent systemic or pulmonary embolus, untreated high-risk proliferative retinopathy, recent retinal hemorrhage, uncontrolled hypertension, systolic BP>180, diastolic BP>105, autonomic neuropathy, resting heart rate >100, electrolyte abnormalities.
  • Aim 2b Exclusion Criteria
  • Subjects must not be receiving any of the following medications: thiazide or furosemide diuretics, beta-blockers, or other chronic medications with known adverse effects on glucose tolerance levels unless the patient has been on a stable dose of such agents for the past three months before entry into the study. Subjects may be taking a stable dose of estrogens or other hormonal replacement therapy, if the subject has been on these agents for the prior three months. Subjects taking systemic glucocorticoids are excluded.
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  • Subjects with a history of clinically significant heart disease (New York Heart Classification greater than grade II; more than non-specific ST-T wave changes on the EKG), peripheral vascular disease (history of claudication), or pulmonary disease (dyspnea on exertion of one flight or less; abnormal breath sounds on auscultation) will not be studied.
  • Recent systemic or pulmonary embolus, untreated high-risk proliferative retinopathy, recent retinal hemorrhage, uncontrolled hypertension, systolic BP>180, diastolic BP>105, autonomic neuropathy, resting heart rate >100, electrolyte abnormalities.
  • Aim 3 Exclusion Criteria
  • Subjects must not be receiving any of the following medications: thiazide or furosemide diuretics, beta-blockers, or other chronic medications with known adverse effects on glucose tolerance levels unless the patient has been on a stable dose of such agents for the past three months before entry into the study. Subjects may be taking a stable dose of estrogens or other hormonal replacement therapy, if the subject has been on these agents for the prior three months. Subjects taking systemic glucocorticoids are excluded.
  • Subjects with a history of clinically significant heart disease (New York Heart Classification greater than grade II; more than non-specific ST-T wave changes on the EKG), peripheral vascular disease (history of claudication), or pulmonary disease (dyspnea on exertion of one flight or less; abnormal breath sounds on auscultation) will not be studied.
  • Recent systemic or pulmonary embolus, untreated high-risk proliferative retinopathy, recent retinal hemorrhage, uncontrolled hypertension, systolic BP>180, diastolic BP>105, autonomic neuropathy, resting heart rate >100, electrolyte abnormalities.
  • Healthy controls with BMI less than 25 who have first degree relatives with Type 2 diabetes are at high risk for insulin resistance, this is an exclusion for this study.

Trial locations and contacts

1 site in 1 country.

Oscar Parra, MADM contact

520-626-6485

oscardp@email.arizona.edu

United States1 site, 1 recruiting
  • The University of Arizona

    Tucson, Arizona, 85724

    Oscar Parra, MADM, 520-626-6485, oscardp@email.arizona.edu

    Lawrence Mandarino, PhD

    Recruiting

Other trials in United States

About this study

The molecular nature of insulin resistance in human muscle is still incompletely defined. Our data indicate that acetylation of mitochondrial proteins in humans is regulated by muscle contraction and is dysregulated in insulin resistance. Poor function of mitochondria in skeletal muscle is a hallmark of insulin resistance in skeletal muscle. We propose to use a combination of clinical research and mass spectrometry techniques to determine how the cytosolic and mitochondrial protein acetylation is regulated by muscle contraction in insulin sensitive and resistant human volunteers. We will test the hypothesis that mitochondrial protein acetylation is decreased to a greater degree following a bout of exercise in insulin sensitive than in insulin resistant human muscle. Using these techniques we also propose to determine how acetylation of mitochondrial adenine nucleotide translocase (ANT1) at lysines 10, 23, and 92 regulates ANT1 structure and function. Finally, we propose 4) to use a combination of molecular modeling and in vitro assays together with the approach developed in Aim 3 to characterize the role of acetylation in other mitochondrial proteins. Protein targets for this aim will be prioritized based on the potential role of the protein in insulin resistance or mitochondrial function as well as dysregulation of its acetylation state in insulin resistant muscle.

Read the detailed description

The purpose of this project has been to define the molecular basis for insulin resistance in human muscle. The preceding two cycles of this project were devoted to using proteomics approaches to map and quantify serine/threonine (S/T) phosphorylation sites on insulin receptor substrate (IRS)-1 in skeletal muscle from healthy and insulin resistant humans.

Recent proteomics experiments reveal that another protein modification, lysine acetylation, is more common in non-histone proteins than has been recognized. There are no data, to our knowledge, regarding a relationship between insulin resistance in vivo in human muscle and protein acetylation. We have used proteomics techniques to discover a number of lysine acetylation sites in skeletal muscle proteins in vivo in humans, and this is prominent in mitochondrial proteins. Preliminary data show that mitochondrial protein acetylation is regulated by muscle contraction, and that this response is reduced in insulin resistance. Finally, the mitochondrial inner membrane protein adenine nucleotide translocase (ANT)1 was abundantly acetylated under resting conditions, and its deacetylation in response to contraction was reduced in insulin resistance. Because ANT1 exerts significant physiological control strength for ADP/ATP exchange, and because mitochondrial function is altered in insulin resistance, it is important to characterize this abnormality. Therefore, in order to determine how abnormalities in regulation of lysine acetylation characterize insulin resistant muscle, we propose:

  1. To determine how the cytosolic and mitochondrial protein acetylomes are regulated by muscle contraction in insulin sensitive and resistant human volunteers. We will test the hypotheses that:
  2. There is differential acetylation of cytosolic or mitochondrial proteins in insulin resistance.
  3. Mitochondrial protein acetylation is decreased to a greater degree following a bout of exercise in insulin sensitive than in insulin resistant human muscle.
  4. To determine how acetylation of the mitochondrial inner membrane adenine nucleotide translocase ANT1 regulates protein structure and function. We will use mitochondria isolated from human muscle biopsies and molecular dynamics and elastic network modeling to test the hypotheses that:
  5. Deacetylation of lysines 10, 23, and 92 increases ANT1 activity.
  6. Oxidation of the mitochondrial matrix (increasing the NAD/NADH ratio) raises deacetylation activity and decreases acetylation of ANT1.
  7. ANT1 molecular dynamics are altered by acetylation of lysines 10, 23, and 92.

These aims that involve clinical research will be complemented by two aims (Aims 1 and 4) performed entirely in vitro, not using human specimens or data. For context, these aims are listed on page 1 of the accompanying Research Proposal. We have retained the numbering scheme from the original proposal to avoid confusion. Please note that only Aims 2 and 3 involve clinical research.

Medical subject headings
Diabetes Mellitus, Type 2, Obesity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT03323827
Study groupRoleWhat they receive
Aim 2aSpecific Aim 2. To determine how the cytosolic and mitochondrial protein acetylomes are regulated by muscle contraction in insulin sensitive and resistant human volunteers. Protocol 2a. Subjects. Two groups (aged 21-65) will be studied: lean (BMI<25), healthy insulin sensitive subjects, and obese (BMI>30) nondiabetics 20 subjects will be enrolled
Aim 2bSpecific Aim 2. To determine how the cytosolic and mitochondrial protein acetylomes are regulated by muscle contraction in insulin sensitive and resistant human volunteers. Protocol 2b (muscle contraction and acetylation) Subjects. Two groups (aged 21-65) will be studied: lean (BMI<25), healthy insulin sensitive subjects, and obese (BMI>30) 32 subjects will be enrolled
Aim 3Specific Aim 3. To determine how acetylation of the mitochondrial inner membrane adenine nucleotide translocase ANT1 regulates protein structure and function. Subjects. Two groups (aged 21-65) will be studied: lean (BMI<25), healthy insulin sensitive subjects, and obese (BMI>30) 20 subjects will be enrolled.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. ANT Acetylation

    Acetylation of adenine nucleotide translocase 1 at lysine 23 in human muscle.

    Measured: 2013-2017

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Oct 2017
  2. Study startNov 2016
  3. Primary completionAug 2018 (estimated)
  4. Study completionAug 2018 (estimated)

Resources

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
Prospective
Enrolment
72 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03323827
Sponsor's protocol ID
1606632714A004
Status last verified
Oct 2017
First submitted
24 Oct 2017
Last updated
27 Oct 2017
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

An observational study of Type 2 Diabetes Mellitus and Obesity, run by University of Arizona 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 18 inclusion and 13 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: status not confirmed, as of the sponsor's last update on 27 Oct 2017. 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?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Oscar Parra, MADM (520-626-6485, oscardp@email.arizona.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

ANT Acetylation (time frame: 2013-2017). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 27 Oct 2017.

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