Obesity Clinical Trial
Official title:
The Effect of GLP-1 Receptor Activation on Central Reward and Satiety Circuits in Response to Food Stimuli in Obesity and Diabetes
Glucagon-like peptide 1 (GLP-1) based therapies, such as exenatide, are already successfully employed in the treatment of Type 2 Diabetes (T2DM). Exenatide improves glycemic control and is associated with reduced food intake and body weight. The investigators hypothesize that it affects central reward and satiety circuits and that this may contribute to the weight loss.
The aim of the project is to determine 1) whether GLP-1 receptor activation of CNS reward
and satiety circuits occurs, in the context of food(-related) stimuli; if this effect is
altered in obese and diabetic compared to lean individuals 2) if it is independent of other
postprandial metabolic and hormonal changes 3) if this effect is GLP-1-receptor-mediated 4)
if the CNS changes correlate with subsequent feeding behaviour.
Methods The investigators will compare 16 obese T2DM-patients, 16 normoglycemic obese and 16
healthy lean individuals, with respect to food(-related) neuronal activity in central reward
and satiety circuits by blood oxygen level-dependent (BOLD) fMRI. fMRI will be performed
during intravenous infusion of a) the GLP-1 receptor agonist exenatide; b) exenatide and a
GLP-1 receptor antagonist (exendin 9-39)(to investigate whether the exenatide-induced
effects are GLP-1-receptor mediated) or c) saline; in randomized order, on separate days. To
tease out concomitant postprandial metabolic and hormonal influences, measurements will be
performed during a somatostatin pancreatic clamp with replacement of basal insulin, glucagon
and growth hormone. Finally, to correlate changes in brain activity with subsequent feeding
behavior, the investigators will measure food intake, self-reported hunger, satiety and
mood, during a choice-buffet after the scanning.
Expected Results This project will gain insight into (CNS) mechanisms underlying the
observed effects of the GLP-1 receptor agonist exenatide on food intake and body weight in
obese, diabetic and healthy lean individuals. These findings may increase our understanding
of the development of obesity and weight loss problems in obese and diabetic individuals and
the role of GLP-1 in the central regulation of feeding behavior/appetite control.
;
Allocation: Randomized, Intervention Model: Crossover Assignment, Masking: Single Blind (Subject)
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