Obesity Clinical Trial
Official title:
Identification and Metabolic Characterization of a Cohort of Human Subjects With Mutations in PRDM-16
Chinese male subjects will be invited to participate in a research study of brown fat, a
special tissue in the body that is designed to burn energy to make heat. The objective is to
learn the importance of a gene called "PRDM-16" for the function of brown fat. Subjects were
selected as a possible subject in this study because they fulfil the age and weight
criteria.
500 subjects from the Singhealth Investigational Medicine Unit healthy volunteer database
will be recruited over a period of 2 years. All of the subjects will have their PRDM-16 gene
sequenced. The objective is to identify subjects with mutations, or changes, in their
PRDM-16 gene. About 12 subjects with PRDM-16 mutations are expected to be identified.
Samples of blood obtained during the course of this study will be stored and analysed only
for the purposes of this study for a period not exceeding 2 years, and will be destroyed
after completion of the study, unless subject is agreeable to donate the samples to the
National Heart Centre Singapore for continuous storage for future studies that are approved
by the institutional review board..
The long-term objective of this study is to develop new treatments for obesity and
obesity-associated disorders such as diabetes and dyslipidemia. The recent finding of active
brown fat depots in adult humans provides an exciting new strategy for the treatment of
these diseases. Brown fat is a specialized organ found primarily in small mammals. Brown fat
has the unique capability to burn fuel at high rates in order to generate heat. The role of
brown fat in mammals is to defend against cold exposure. Human infants have active brown fat
deposits located in the intra-scapular region. This brown fat depot regresses with age and
it was long thought that adult humans had no brown fat tissue. Recent studies have
demonstrated the presence of brown fat activity in adult humans following exposure to cold.
Brown fat in adult humans is concentrated in the cervical region and displays some
sex-specific differences. Furthermore the size of the depot is inversely correlated with BMI
and age of the subjects. This finding has generated intense interest as it opens up the
possibility of harnessing brown fat as a means of combating obesity and obesity-related
disorders in man. Indeed, maneuvers that activate brown fat in humans have been shown to
cause reductions in fat mass.
Much of our understanding of brown fat biology comes from work in mice. Of particular
relevance for the treatment of human disease are several findings. First, increasing brown
fat activity in mice renders the animals resistant to the development of obesity on a high
fat diet. Second, levels of insulin sensitivity are directly related to brown fat activity.
Finally, the transcription factor factor PR-domain containing protein 16 (PRDM-16) is
crucial for directing the biology of brown fat.
The overall goal of the study is to translate the findings from mouse studies of brown fat
into human subjects. This is an important first step in the process of developing brown
fat-targeted therapies to treat human metabolic diseases such as obesity and insulin
resistance. In view of this the investigators are interested in answering several questions.
First, do humans with mutations in PRDM-16 have defects in brown fat activity? Recently,
humans with mutations in PRDM-16 were identified and found to have a cardiomyopathy
phenotype. The brown fat function in these individuals has not been described. By employing
a genetic screen of volunteers the investigators hope to identify subjects in Singapore with
defects in PRDM-16. Prior studies in humans suggest that the size of the brown fat depot is
inversely correlated with BMI and age of the subjects and that depot size varies between the
sexes. In order to eliminate BMI, age and sex as confounding variables the investigators
will include male subjects of Chinese race between the ages of 21 and 50 and with BMI
greater than 18.5 but less than 30. The investigators will include only Chinese subjects to
avoid confounding our initial study with variables that relate to race of the subjects. The
identification of human subjects carrying mutations in PRDM-16 will set the stage for
further studies that will attempt to several research questions. These include whether
humans with PRDM-16 mutations have defects in brown fat and the metabolic consequences for
humans with defective brown fat.
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Observational Model: Case Control, Time Perspective: Prospective
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