Diabetes Mellitus, Type 2 Clinical Trial
Official title:
Mitochondrial Dysfunction in Type 2 Diabetes Mellitus and Capacity for Fat Oxidation During Exercise
The purpose of this study is to compare the effects of an 8-week aerobic training program
upon fat oxidation in vivo and markers of skeletal muscle mitochondrial content and
oxidative capacity in sedentary obese subjects with and without type 2 diabetes. We will
also investigate if mitochondrial content in muscle predicts success of weight loss.
The specific aims are:
- To compare systemic fat oxidation rates;
- To measure mitochondrial content in muscle before and after aerobic training;
- To determine if decreased mitochondrial content is also associated with decreased
mitochondrial oxidative capacity;
- To measure non-plasma fatty acid oxidation in vivo during submaximal exercise
conditions both prior and after aerobic training;
- To determine whether increases in fat oxidation due to physical activity predict weight
loss success when a reduced calorie diet is added to a physical activity program.
During prolonged moderate-intensity exercise, skeletal muscle gradually increases its
metabolic reliance on fat oxidation. In healthy subjects, this adaptation is enhanced by
aerobic training and is associated with increased mitochondrial capacity in muscle. Whether
or not subjects with type-2 diabetes (T2DM) respond to exercise training with similar
metabolic and mitochondrial adaptations is yet to be demonstrated. Skeletal muscle
mitochondrial oxidative capacity has been shown to be deficient in T2DM, suggesting a
compromised physiologic reserve that might have implications for the metabolic plasticity of
muscle during exercise.
This study will test the hypothesis that fat oxidation rates during exercise are poorly
responsive to training in T2DM, being correlated to the degree of muscle mitochondrial
adaptation. The effects of a 16-week intervention (8 weeks of exercise intervention followed
by 10-12 weeks of weight loss intervention) on systemic fat oxidation during exercise and
mitochondrial capacity will be compared between 3 sedentary subject groups; 15 lean
subjects, 15 overweight subjects with T2DM, and 15 overweight subjects without diabetes. The
first aim is to compare the degree of improvement in fat oxidation during submaximal
exercise obtained by indirect calorimetry. The second and third aims are, respectively, to
compare the degree of improvement in mitochondrial content and oxidative capacity in muscle
biopsy samples. The fourth aim is to determine whether fat oxidation from non-plasma sources
is increased by the intervention. The final aim is to examine whether improvements in fat
oxidation predict degree off success in a subsequent weight loss program.
The results of this study will be relevant to the understanding of the mechanisms by which
exercise training confers metabolic improvements in T2DM. In addition, this study will
address whether perturbations in mitochondria could explain why obese individuals with T2DM
might have difficulty with fat disposal.
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Allocation: Non-Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Basic Science
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