Insulin Resistance Clinical Trial
Official title:
Novel Therapy for Glucose Intolerance in HIV Disease
This research is to investigate the nutritional supplement chromium picolinate. The investigators are testing to see how effective this supplement is in treating insulin resistance associated with HIV disease.
This study will test the hypothesis that chromium picolinate improves insulin-stimulated
glucose uptake by increasing the insulin receptor-mediated tyrosine phosphorylation of
insulin receptor substrate-1, resulting in increased association with phosphatidylinositol
3-kinase.
Specific Aim 1 will assess quantitative improvements in insulin-mediated glucose disposal in
a placebo-controlled clinical trial of chromium supplementation with 1000mpg (19.2 pmol) of
chromium as chromium picolinate, overa two-month course of therapy. The investigators have
shown that the insulin resistance (i.e. the inability of insulin to stimulate glucose uptake
into peripheral tissues like muscle) in patients with HIV disease is associated with a
defect in the insulin-signaling pathway leading from the insulin receptor, through
phosphatidylinositol 3-kinase(PI 3-K, Figure 5). A similar defect in intracellular signaling
has also been reported in patients with type 2 diabetes mellitus ):15-171. The cellular
mechanism of improved insulin sensitivity with chromium supplementation will be determined
in Specific Aim 2.
Specific Aim 2 will assess the effect of chromium supplementation on the insulin-stimulated
activity of insulin receptor substrate-I-associated phosphatidylinositol 3-kinase in
biopsies of muscle and fat tissue. This aim will also test the hypothesis that these
physiological effects of chromium are mediated by alterations in the activity of insulin
signaling. Understanding this mechanism may facilitate the design of even more effective
strategies for improving insulin sensitivity.
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Observational Model: Case Control, Time Perspective: Prospective
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