Effects of Acipimox on Mitochondrial Function in Obesity

Insulin Resistance Clinical Trial

Official title:

The Effects of Short Term Acipimox Treatment on Skeletal Muscle Phosphocreatine Recovery in Obesity

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01488409
• Other study ID #: 2011-P-000175
• Status: Completed
• Phase: Phase 2
• First received: December 2, 2011
• Last updated: February 2, 2016
• Start date: May 2012
• Est. completion date: January 2015

Study information

• Verified date: February 2016
• Source: Massachusetts General Hospital
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

The purpose of the study is to examine whether a medication called acipimox can improve your body's mitochondria. Mitochondria are the "power house" of the cell and make energy for your body.

Obesity is associated with increased risk for developing diabetes. However, the investigators do not know how obesity leads to diabetes. Previous studies have shown levels of fat in the blood (free fatty acids or FFA) are higher in obesity, and elevated FFA can affect how our body uses glucose and responds to insulin. Recent studies have shown that changes in mitochondria may be involved in the development of diabetes and may be affected by FFA. The investigators propose to improve the function of mitochondria in obese people with pre-diabetes by treating with acipimox, a medication which decreases FFA. The investigators will use state of the art techniques to evaluate the mitochondria, including a new magnetic resonance imaging (MRI) technique to measure function of mitochondria in muscle.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 39
• Est. completion date: January 2015
• Est. primary completion date: January 2015
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years to 55 Years

Eligibility

Inclusion Criteria:

1. Men and women age 18-55 years old

2. Body Mass Index (BMI) = 30 kg/m2

3. Waist circumference = 102 cm in men and = 88 cm in women

4. Hypertriglyceridemia defined as triglycerides = 150 mg/dl OR Insulin resistance defined as elevated fasting glucose (= 100 mg/dl but <125 mg/dl) or hyperinsulinemia defined as fasting serum insulin = 10 uU/ml.

Exclusion Criteria:

1. Subjects on any hormonal treatment including estrogen, hormone replacement therapy, oral contraceptives, testosterone, glucocorticoids, anabolic steroids, GH, GH releasing hormone or Insulin like growth factor (IGF)-1 within 3months of enrollment.

2. Subjects who have a known history of diabetes, using any anti-diabetic drugs, or fasting blood glucose of = 125 mg/dl.

3. Use of cholesterol lowering medication including niacin or fish oil.

4. Changes in anti-hypertensive regimen within 3months of screening.

5. Chronic illness including HIV, anemia (Hgb <12 g/dL), chronic kidney disease (Creatinine > 2 mg/dL), or liver disease (SGOT > 2.5 x upper limit normal).

6. Use of Aspirin, Clopidogrel (Plavix), Warfarin (Coumadin) or other anti-coagulants

7. History of or active peptic ulcer disease

8. History of any recent cardiovascular event including myocardial infarction (MI; heart attack), cerebral vascular accident (CVA; or stroke) or transient ischemic attack (TIA; or mini-stroke) within 3 months of screening visit, unstable angina pectoris, oxygen-dependent severe pulmonary disease

9. Subjects with contraindication for an MRI study including any significant metal in their body including surgical clippings, or pacemakers and known claustrophobia.

10. History of recent alcohol or substance abuse (< 1 year)

11. Positive pregnancy test or lactating females

12. Women of child-bearing potential not currently using non-hormonal birth control methods including barrier methods (intra-uterine device or IUD, condoms, diaphragms) or abstinence

13. Subject is currently enrolled in another investigational device or drug trial(s), or subject has received other investigational agent(s) within 28 days of baseline visit.

Study Design

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Related Conditions & MeSH terms

• Abdominal Obesity
• Hypertriglyceridemia
• Insulin Resistance
• Obesity
• Obesity, Abdominal

Intervention

Drug:
• Acipimox
250 mg by mouth (PO) three times daily
• Placebo
0 mg by mouth (PO) three times daily

Locations

Country	Name	City	State
United States	Massachusetts General Hospital	Boston	Massachusetts

Sponsors (2)

Lead Sponsor	Collaborator
Massachusetts General Hospital	American Diabetes Association

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change From Baseline in Phosphocreatine Recovery (ViPCr) at 6-months	The rate of recovery of phosphocreatine concentration after depletion by exercise is considered a measurement of mitochondrial function. Change in phosphocreatine recovery from baseline to 6 months will therefore give a measurement of change in mitochondrial function. ViPCR is given -- a higher value indicates better mitochondrial function.	Change from Baseline to 6-months Visit	No
Secondary	Change From Baseline in Insulin Sensitivity at 6-months	Change in insulin resistance assessed by hyperinsulinemic-euglycemic clamp study at Baseline and at 6-months. Change in insulin-stimulated glucose uptake (M) during 40 mU/m2/min insulin clamp is given.	Change from Baseline to 6-months visit	No
Secondary	Change From Baseline in Mitochondrial Density at 6 Months	Muscle tissue obtained from biopsy will be used to assess mitochondrial number and morphology by microscopes at Baseline and at 6-months. The change in mitochondrial density from 6 months to baseline is given.	Change from Baseline to 6-months	No
Secondary	Change From Baseline in Intramyocellular Lipid Content at 6-months	Change in tibialis intramyocellular lipid (IMCL) normalized to creatinine is given.	Change from Baseline to 6-months	No
Secondary	Change From Baseline in Lipid Profile at 6-months	Change in direct low density lipoprotein (LDL) cholesterol is given	Change from Baseline to 6-months	No