Obesity Clinical Trial
Official title:
Effect of Nicotinic Acid on Adipose Tissue Inflammation in Obese Subjects
Our working hypothesis postulates that lipolysis is a determinant of inflammation in adipose
tissue (AT). Inhibition of lipolysis, e.g. using the oldest normolipidemic drug, nicotinic
acid, has proved valuable to combat the metabolic syndrome. Our proposal will determine
whether part of the beneficial effects of this antilipolytic compound is due to a diminution
of AT inflammation.
To this aim, the effect of nicotinic acid or placebo will be studied in male obese subjects
with or without a training program which goal is to enhance lipolysis.
24 male obese insulin resistant subjects will receive nicotinic acid or placebo for 16 weeks.
The last 8 weeks, the subjects will follow a training program calculated to optimize use of
lipid. Insulin sensitivity and glucose tolerance will be assessed using, respectively,
fasting-based estimates of insulin sensitivity (plasma and muscle) and oral glucose tolerance
test. Plasma parameters of adipokines and, inflammatory and metabolic parameters will be
determined. As an index of AT inflammation, the percentage and the phenotype of macrophages
will be determined using flow cytometry of cells of the stromavascular fraction of
subcutaneous AT. Macrophage infiltration will be investigated by light microscopy. The
characterization of the inflammatory profile of AT will be completed by measurements of the
expression of genes that are either specific markers of human AT macrophages or inflammatory
and anti-inflammatory adipokines. This combination of approaches has never been carried out
during a pharmacological intervention in humans. The following points will be addressed:
- determine the influence of lipolysis on AT inflammation, specifically on macrophage
activation and adipokine production.
- examine the causal relationship between adipocyte FA metabolism, AT inflammation and
insulin sensitivity.
- establish whether the beneficial effect of antilipolytic drugs may be attributable at
least in part to a decrease in AT inflammation.
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