Healthy Clinical Trial
Official title:
THE RELATIONSHIP BETWEEN BODY COMPOSITION AND GROWTH HORMONE, SIRT SIGNALING, PROTEIN TURNOVER AND INSULIN SENSITIVITY. Studies of Signaling Pathways in Fat and Muscle, and Turnover of Protein, Sugar and Fat After Stimulation With Growth Hormone and During Fasting in Lean and Obese Subjects
The purpose of this study is to investigate signaling pathways in fat and muscle, as well as turnover of protein, sugar and fat after stimulation with growth hormone and during fasting in lean and obese subjects. This will help clarify differences in the human metabolism between lean and obese subject and provide us with a better understanding of the molecular mechanisms regulating the basic metabolism during prolonged fasting.
In an evolutionary context, it is likely that "inherited" obesity provides a survival
advantage when there are shortages of food, but also increases the risk of lifestyle
diseases in times of prosperity. This may explain the high incidence of obesity, diabetes
and cardiovascular disease in the western world today. Obese individuals have high levels of
free fatty acids (FFAs) in the blood and FFAs are both protein sparing (giving an
evolutionary survival advantage) but also cause increased insulin resistance (which
increases the risk of diabetes and cardiovascular disease). Obesity also leads to low growth
hormone (GH)-levels, whereas fasting is accompanied by high GH- and FFA-levels and increased
IGF-I mRNA in muscle. It is likely that obese individuals are more capable of fasting than
lean individuals and will lose less protein during fasting, have increased activation of GH
signaling and altered activation of other signaling proteins. And obese individuals are
likely to be more sensitive to growth hormone than lean individuals based on FFA-responses,
intracellular signaling, protein loss and insulin sensitivity.
We would like to test 3 hypotheses: (1) Obese individuals are more capable of fasting than
lean individuals and will lose less protein during fasting (2) Activation of lipolysis is an
important prerequisite for limiting protein loss during fasting in both slim as obese
individuals. (3) Obese individuals are more sensitive to growth hormone than lean
individuals based on FFA responses and activation of intracellular signals. The hypotheses
are tested in 8 lean and 8 obese healthy young men, who are studied 4 times: (i) after 12
hours of fasting (ii) after 72 hours of fasting (iii) after GH-bolus (0.005 mg/kg over 20
min.) and (iv) after 72 hours of fasting with inhibition of fat metabolism (tablet acipimox
250 mg every 4 hours) during the last 12 hours of fasting and during the study period.
Each study period consists of a 4-hour basal period and a 2 hour hyperinsulinemic euglycemic
clamp (30 mU/m2/min). Muscle- and fat-biopsies are taken and analyzed for enzyme expression
and activation of various signaling pathways. The study subjects are given glucose-, amino
acid-, urea- and palmitate-tracers and specific hormones and metabolites are measured for
assessment of underlying molecular mechanisms regulating the basic human energy metabolism.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Basic Science
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