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Metabolic Syndrome, Protection AgainstMMETNCT04477590

Interactions of Medicine and Exercise With Meal Timing

A study testing EXERCISE TRAINING WITH OR WITHOUT MEDICATION in people with Metabolic Syndrome, Protection Against and Exercise Training, run by University of Castilla-La Mancha at 1 site in Spain.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

To analyze the effects of altering the time of ingestion of participants' habitual medication (i.e., metformin, statins, ARAII/IACE) and meals around the time of exercise training (exercise fasted or fed) on the improvement of metabolic syndrome factors (hypertension, insulin sensitivity, dyslipidemia, and obesity). Read more about this study

Who is it for?
Ages 18 to 70 years
What is being tested?
EXERCISE TRAINING WITH OR WITHOUT MEDICATION
Could I receive a placebo?
No, everyone receives an active treatment
How many people
160 participants
Where
1 siteSpain
Study dates
7 Jun 2022to 30 Dec 2024
Phase
Interventional
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 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Metabolic syndrome patients diagnosed according to The International diabetes federation consensus of 2009 (Alberti, et al., Circulation).

Who cannot join

  • Cardiovascular disease or musculo-skeletal that prevents them from being able to perform intense exercise.
  • Respiratory failure
  • Liver o renal disease
  • Pregnancy

Trial locations and contacts

1 site in 1 country.

Ricardo Mora-Rodriguez, PhD contact

925268800

ricardo.mora@uclm.es

Juan F Ortega, MD, PhD contact

925268800

juanfernando.ortega@uclm.es

Spain1 site, 1 recruiting
  • University of Castilla-La Mancha (Exercise Physiology Lab)

    Toledo, 45071

    Ricardo Mora-Rodriguez, PhD, 92526800 ext. 5515, ricardo.mora@uclm.es

    Juan F Ortega, MD, PhD, +3492526800 ext. 5515, juanfernando.ortega@uclm.es

    Recruiting

Other trials in Spain

About this study

Official title: Optimizing Exercise Training Effects on Metabolic Syndrome Factors by Altering the Timing of Medication and Meal Ingestion

To analyze the effects of altering the time of ingestion of participants' habitual medication (i.e., metformin, statins, ARAII/IACE) and meals around the time of exercise training (exercise fasted or fed) on the improvement of metabolic syndrome factors (hypertension, insulin sensitivity, dyslipidemia, and obesity). There will be a preliminary study of the effects of training "time-of-day" on the primary study outcomes.

Read the detailed description

Objective: The purpose is to study in a group of adults with metabolic syndrome and obesity, the effects of altering timing between exercise training, meals, and their habitual medication on the improvement in the factors that compose the metabolic syndrome (i.e., hypertension, insulin resistance, central obesity, and dyslipidemia). The main objective is to find the most productive combination between exercise training and the timing of their habitual pharmacological treatment, and meal ingestion for lowering those factors.

Methods and design: Cross-over randomized double-blinded, pretest-posttest control group experimental design. The project will be developed in a single center with the collaboration of the regional public health system (SECAM). There will be a preliminary study of the effects of training "time-of-day" on three parallel groups of individuals.

Subjects: Will be referred by their primary care physicians to our study unit or recruited by advertisements in local media.

Up to 180 subjects, all of them with metabolic syndrome will be recruited (>25% women).

Measurements:

Specifically, we will study if the cardiovascular and metabolic adaptations to aerobic training that result in amelioration of metabolic syndrome factors are potentiated by correct timming of training, meals, and medicine around exercise training time.

Being tested
EXERCISE TRAINING WITH OR WITHOUT MEDICATION
Keywords
Cardiorespiratory fitness, Insulin sensitivity, Dyslipidemia, Hypertension
Medical subject headings
Metabolic Syndrome, Intermittent Fasting, Insulin Resistance, Dyslipidemias, Hypertension

What participants receive

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

  • EXERCISE TRAINING WITH OR WITHOUT MEDICATIONDrug

    Also called Exercise timing with respect to medication (metformin, statins, ARAII/ACEI)

    A group will train 30 min after taking their habitual dose of medicine (MEDICATED train) while another group will train after taking a placebo (NON-MEDICATED train) and will receive their medication after training.

Study groups in NCT04477590
Study groupRoleWhat they receive
NO EXERCISE TRAININGNo intervention25-32 individuals with metabolic syndrome that will remain sedentary during the 4 months of treatment taking their habitual medication (i.e., blood pressure, glucose, cholesterol, and triglycerides lowering drugs) and meals at the habitual time (CONTROL GROUP).
EXERCISE TRAINING FEDExperimental2 groups of 25-32 individuals with metabolic syndrome that will exercise-train during 16 weeks after ingesting a liquid test meal (500 calls, 50% fat) 30 min before exercise (EXERCISE TRAINING FED).
Receives: Drug: EXERCISE TRAINING WITH OR WITHOUT MEDICATION
EXERCISE TRAINING FASTEDExperimental2 groups of 25-32 individuals with metabolic syndrome that will exercise-train during 16 weeks after ingestion of a placebo meal (0 kcals) 30 min before exercise (EXERCISE TRAINING FAST).
Receives: Drug: EXERCISE TRAINING WITH OR WITHOUT MEDICATION

What is being measured

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

  1. Insulin sensitivity assessed using intravenous glucose tolerance test

    Curves of insulin-mediated glucose clearance, inhibition of lipolysis, and liver glucose output measured with the use of stable isotope infusion.

    Measured: 12 months

  2. Post-prandial lipemia assessed by an oral fat tolerance test

    Rates of appearance and clearance of liver VLDL-TG, Apolipoprotein B, and fatty acids using stable isotopes.

    Measured: 12 months

  3. Blood pressure assessed by ECG-gated automated sphygmomanometer

    Determined immediately after treatments and during the following 24-h using ambulatory blood pressure Holter-type monitors.

    Measured: 12 months

  4. Glycemic control assessed by 24-h continuous interstitial glucose monitoring

    Determined by a patch glucose sensor paired with a glucose monitor.

    Measured: 36 months

Secondary outcomes (7)
  1. Body composition.

    Determined by bioelectrical impedance to calculate body fat mass and fat free mass.

    Measured: 12 months

  2. Body mass index

    Determined by body weight (kg) and height (m) to calculate body mass index (kg/m2)

    Measured: 12 months

  3. Maximal oxygen consumption during a graded exercise test to exhaustion, assessed by indirect calorimetry

    Calculation of cardiorespitarory fitness

    Measured: 12 months

  4. Resting metabolic rate assessed by indirect calorimetry while lying after an overnight fast

    Using indirect calorimetry and a ventilated canopy system

    Measured: 12 months

  5. Maximal rate of fat oxidation assessed by indirect calorimetry during a submaximal exercise test.

    Calculated in grams per min during the incremental cycle ergometer test with the use of indirect calorimetry system

    Measured: 12 months

  6. 24-hour monitoring of blood concentrations of metformin, statins, and angiotensin blockers assessed using gas chromatography-mass spectrometry.

    To study the pharmacokinetics of the habitual medicines used by our subjects during the different experimental conditions

    Measured: 36 months

  7. The activity of intramuscular proteins (enzymes) involved in energetics assessed using western blots.

    Measured in skeletal muscle obtained by percutaneous muscle biopsy.

    Measured: 36 months

Timeline

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

  1. First posted20 Jul 2020
  2. Study start7 Jun 2022
  3. Primary completion30 May 2024 (estimated)
  4. Study completion30 Dec 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
Cross-over randomized, pretest-posttest control group experimental design.
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
160 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04477590
Sponsor's protocol ID
DEP2017-83244-R
Acronym
MMET
Status last verified
Aug 2023
First submitted
28 Jun 2020
Last updated
25 Aug 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Upon reasonable request

Publications

  • Ortega JF, Hamouti N, Fernandez-Elias VE, de Prada MV, Martinez-Vizcaino V, Mora-Rodriguez R. Metformin does not attenuate the acute insulin-sensitizing effect of a single bout of exercise in individuals with insulin resistance. Acta Diabetol. 2014 Oct;51(5):749-55. doi: 10.1007/s00592-014-0580-4. Epub 2014 Mar 29.

    PubMed 24682492
  • Mora-Rodriguez R, Ortega JF, Guio de Prada V, Fernandez-Elias VE, Hamouti N, Morales-Palomo F, Martinez-Vizcaino V, Nelson RK. Effects of Simultaneous or Sequential Weight Loss Diet and Aerobic Interval Training on Metabolic Syndrome. Int J Sports Med. 2016 Apr;37(4):274-81. doi: 10.1055/s-0035-1564259. Epub 2015 Dec 14.

    PubMed 26667921
  • Alvarez-Jimenez L, Moreno-Cabanas A, Ramirez-Jimenez M, Morales-Palomo F, Ortega JF, Mora-Rodriguez R. Effects of statins and exercise on postprandial lipoproteins in metabolic syndrome vs metabolically healthy individuals. Br J Clin Pharmacol. 2021 Mar;87(3):955-964. doi: 10.1111/bcp.14447. Epub 2020 Jul 12.

    PubMed 32598033
  • Mora-Rodriguez R, Ortega JF, Morales-Palomo F, Ramirez-Jimenez M, Moreno-Cabanas A. Effects of statin therapy and exercise on postprandial triglycerides in overweight individuals with hypercholesterolaemia. Br J Clin Pharmacol. 2020 Jun;86(6):1089-1099. doi: 10.1111/bcp.14217. Epub 2020 Feb 18.

    PubMed 31925809
  • Morales-Palomo F, Ramirez-Jimenez M, Ortega JF, Moreno-Cabanas A, Mora-Rodriguez R. Exercise Training Adaptations in Metabolic Syndrome Individuals on Chronic Statin Treatment. J Clin Endocrinol Metab. 2020 Apr 1;105(4):dgz304. doi: 10.1210/clinem/dgz304.

    PubMed 31875915
  • Guio de Prada V, Ortega JF, Morales-Palomo F, Ramirez-Jimenez M, Moreno-Cabanas A, Mora-Rodriguez R. Women with metabolic syndrome show similar health benefits from high-intensity interval training than men. PLoS One. 2019 Dec 10;14(12):e0225893. doi: 10.1371/journal.pone.0225893. eCollection 2019.

    PubMed 31821339
  • Moreno-Cabanas A, Ortega JF, Morales-Palomo F, Ramirez-Jimenez M, Mora-Rodriguez R. Importance of a verification test to accurately assess V̇O2 max in unfit individuals with obesity. Scand J Med Sci Sports. 2020 Mar;30(3):583-590. doi: 10.1111/sms.13602. Epub 2019 Dec 11.

    PubMed 31746500
  • Morales-Palomo F, Ramirez-Jimenez M, Ortega JF, Mora-Rodriguez R. Effectiveness of Aerobic Exercise Programs for Health Promotion in Metabolic Syndrome. Med Sci Sports Exerc. 2019 Sep;51(9):1876-1883. doi: 10.1249/MSS.0000000000001983.

    PubMed 31415443
  • Mora-Rodriguez R, Ortega JF, Ramirez-Jimenez M, Moreno-Cabanas A, Morales-Palomo F. Insulin sensitivity improvement with exercise training is mediated by body weight loss in subjects with metabolic syndrome. Diabetes Metab. 2020 Jun;46(3):210-218. doi: 10.1016/j.diabet.2019.05.004. Epub 2019 May 31.

    PubMed 31158474
  • Mora-Rodriguez R, Ortega JF, Morales-Palomo F, Ramirez-Jimenez M. Weight loss but not gains in cardiorespiratory fitness after exercise-training predicts improved health risk factors in metabolic syndrome. Nutr Metab Cardiovasc Dis. 2018 Dec;28(12):1267-1274. doi: 10.1016/j.numecd.2018.08.004. Epub 2018 Aug 23.

    PubMed 30459053
  • Ramirez-Jimenez M, Morales-Palomo F, Ortega JF, Mora-Rodriguez R. Effects of intense aerobic exercise and/or antihypertensive medication in individuals with metabolic syndrome. Scand J Med Sci Sports. 2018 Sep;28(9):2042-2051. doi: 10.1111/sms.13218. Epub 2018 Jun 4.

    PubMed 29771450
  • Morales-Palomo F, Moreno-Cabanas A, Alvarez-Jimenez L, Mora-Gonzalez D, Ortega JF, Mora-Rodriguez R. Efficacy of morning versus afternoon aerobic exercise training on reducing metabolic syndrome components: A randomized controlled trial. J Physiol. 2024 Dec;602(23):6463-6477. doi: 10.1113/JP285366. Epub 2023 Nov 28.

    PubMed 38015017

Questions about this trial

What is this clinical trial studying?

A study testing EXERCISE TRAINING WITH OR WITHOUT MEDICATION in people with Metabolic Syndrome, Protection Against and Exercise Training, run by University of Castilla-La Mancha at 1 site in Spain.

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 1 inclusion and 4 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 25 Aug 2023. 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 Spain. 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 Ricardo Mora-Rodriguez, PhD (925268800, ricardo.mora@uclm.es), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Insulin sensitivity assessed using intravenous glucose tolerance test (time frame: 12 months). The study lists 4 primary outcomes in all. 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 NCT04477590, which also lists 12 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 25 Aug 2023.

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