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Dietary Modulation of Gene Expression and Metabolic Pathways in Glucose Metabolism (Sysdimet)

Primary Purpose

Metabolic Syndrome, Obesity, Impaired Glucose Tolerance

Status
Completed
Phase
Phase 2
Locations
Finland
Study Type
Interventional
Intervention
Diet with increased intake of rye bread, berries and fish
Increased intake of whole grain and rye bread
Control diet with decreased intake of rye bread, berries and fish
Sponsored by
Marjukka Kolehmainen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metabolic Syndrome focused on measuring Systems biology, Nutrigenomics, Metabolomics, Gene expression, Fat tissue, Peripheral mononuclear cells, Gene clusters, Gene expression profiles, Personal diets, Metabolic syndrome, Type 2 Diabetes, Atherosclerosis

Eligibility Criteria

40 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • impaired glucose tolerance (oral glucose tolerance test with 2-h glucose concentration 7,8-11,0 mmol/l) OR
  • impaired fasting glucose fasting plasma glucose concentration 5,6-6,9 mmol/l = IFG)
  • and two of the criteria for metabolic syndrome:
  • BMI 26-39 kg/m2
  • Waist circumference > 102 cm (men) or > 88 cm (women)
  • hypertriglyceridemia (fasting serum triglyceride conc > 1,7 mmol/l),
  • HDL-cholesterol (fasting serum HDL conc < 1,0 mmol/l for men and < 1,3 mmol/l for women)
  • Blood pressure ≥ 130/≥ 85 mmHg

Exclusion Criteria:

  • BMI > 40 kg/m2
  • fasting serum triglyceride conc > 3.5 mmol/l
  • fasting serum cholesterol > 8 mmol/l
  • type 1 or 2 diabetes
  • abnormal liver, kidney or thyroid function
  • large alcohol intake (women >16, men > 24 doses (4cl liquor or equivalent) during week)
  • inflammatory bowel disease
  • disease that prevents participation
  • neuroleptic neuroleptic cortisone medication

Sites / Locations

  • University of Kuopio, Department of Clinical Nutrition

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

A

B

C

Arm Description

Diet with increased intake of rye bread, berries and fish

Increased intake of whole grain and rye bread

Control diet with decreased intake of rye bread, berries and fish

Outcomes

Primary Outcome Measures

Changes in glucose metabolism, changes in transcriptomic and metabolomic profiles

Secondary Outcome Measures

Interaction between the diet and genetic factors within treatment groups

Full Information

First Posted
December 13, 2007
Last Updated
April 16, 2012
Sponsor
Marjukka Kolehmainen
Collaborators
VTT Technical Research Centre, Finland, Wageningen University
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1. Study Identification

Unique Protocol Identification Number
NCT00573781
Brief Title
Dietary Modulation of Gene Expression and Metabolic Pathways in Glucose Metabolism
Acronym
Sysdimet
Official Title
Systems Biology Approach to Understand Dietary Modulation of Gene Expression and Metabolic Pathways in Subjects With Abnormal Glucose Metabolism (Sysdimet)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2012
Overall Recruitment Status
Completed
Study Start Date
September 2007 (undefined)
Primary Completion Date
June 2009 (Actual)
Study Completion Date
June 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Marjukka Kolehmainen
Collaborators
VTT Technical Research Centre, Finland, Wageningen University

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Professor Matti Uusitupa, University of Kuopio, Department of Clinical Nutrition (www.uku.fi) Docent Matej Oresic, VTT (www.vtt.fi) Ursula Schwab, PhD, Docent, Marjukka Kolehmainen, PhD, Docent, Leena Pulkkinen, PhD, Docent, David Laaksonen, MD, PhD, MPH, Docent, Kaisa Poutanen, DSc (Tech), Research Professor ABSTRACT The metabolic syndrome (MS) and type 2 diabetes (T2DM) are the most important health problems worldwide. In Finland the prevalence of T2DM is 12-15% among middle-aged people. The prevalence of less marked disturbances in glucose metabolism and MS is 30-40%. Because MS and T2DM are important risk factors for cardiovascular diseases (CVD), the leading cause of death in western countries, all efforts to reverse the epidemic increase in the incidence of MS and T2DM are warranted. The investigators have focused for years on the prevention and non-pharmacological treatment of T2DM and its complications including studies on genetic regulation of glucose and lipid metabolism after dietary modifications. In the investigators' recent projects, the investigators have studied the effects of long-term dietary interventions on gene expression profiles of fat tissue in subjects who are at risk of T2DM. The ultimate goal of these projects has been to identify genes and gene clusters and their biological pathways that respond to dietary modification and modulate glucose and lipid metabolism, and to develop dietary strategies for prevention of T2DM. The main goal of this project is to find nutrition related early biomarkers for progression of MS to T2DM by using modern technologies of systems biology (transcriptomics, metabolomics) of carefully conducted dietary interventions involving subjects with MS. The data will be analysed by using bioinformatics. The investigators reflect these new data to well-known risk factors for T2DM and CVD, e.g., insulin sensitivity, insulin secretion, serum lipids and inflammatory factors among others. In addition to interventions conducted earlier, a new intervention with a whole grain-berry-fish diet and a whole grain diet compared to a control diet with refined foods will be performed. The aim is to increase the investigators' understanding on the synergistic effects of these foods, because the investigators' previous interventions have shown that these individual foods have beneficial effects on glucose and lipid metabolism. On the contrary, diets with refined foods may be harmful in long-term due to its high insulin response, which may through chronic stress lead to both insulin resistance and beta-cell damage. The significance of this project is to increase understanding of the pathophysiology of MS, T2DM and CVD in physiological, cellular and genetic systems, which may lead to more effective and individualised strategies for treatment and prevention, and better identification of high-risk individuals responsive to specific dietary modifications. Increasing knowledge of dietary factors involved in the progression of MS to T2DM and CVD offers new opportunities to individually tailored diets in the management and prevention of these disorders. The results will also be beneficial for the food industry in developing new functional foods. These results and actions may help delay or even stop the epidemic of MS and T2DM and their negative effect on public health currently seen in Finland and worldwide.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metabolic Syndrome, Obesity, Impaired Glucose Tolerance, Impaired Fasting Glucose
Keywords
Systems biology, Nutrigenomics, Metabolomics, Gene expression, Fat tissue, Peripheral mononuclear cells, Gene clusters, Gene expression profiles, Personal diets, Metabolic syndrome, Type 2 Diabetes, Atherosclerosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
106 (Actual)

8. Arms, Groups, and Interventions

Arm Title
A
Arm Type
Experimental
Arm Description
Diet with increased intake of rye bread, berries and fish
Arm Title
B
Arm Type
Experimental
Arm Description
Increased intake of whole grain and rye bread
Arm Title
C
Arm Type
Active Comparator
Arm Description
Control diet with decreased intake of rye bread, berries and fish
Intervention Type
Dietary Supplement
Intervention Name(s)
Diet with increased intake of rye bread, berries and fish
Intervention Description
Dietary modification with commercial food items
Intervention Type
Dietary Supplement
Intervention Name(s)
Increased intake of whole grain and rye bread
Intervention Description
Dietary modification with commercial food items
Intervention Type
Dietary Supplement
Intervention Name(s)
Control diet with decreased intake of rye bread, berries and fish
Intervention Description
Dietary modification with commercial food items
Primary Outcome Measure Information:
Title
Changes in glucose metabolism, changes in transcriptomic and metabolomic profiles
Time Frame
By 2010
Secondary Outcome Measure Information:
Title
Interaction between the diet and genetic factors within treatment groups
Time Frame
By 2010

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: impaired glucose tolerance (oral glucose tolerance test with 2-h glucose concentration 7,8-11,0 mmol/l) OR impaired fasting glucose fasting plasma glucose concentration 5,6-6,9 mmol/l = IFG) and two of the criteria for metabolic syndrome: BMI 26-39 kg/m2 Waist circumference > 102 cm (men) or > 88 cm (women) hypertriglyceridemia (fasting serum triglyceride conc > 1,7 mmol/l), HDL-cholesterol (fasting serum HDL conc < 1,0 mmol/l for men and < 1,3 mmol/l for women) Blood pressure ≥ 130/≥ 85 mmHg Exclusion Criteria: BMI > 40 kg/m2 fasting serum triglyceride conc > 3.5 mmol/l fasting serum cholesterol > 8 mmol/l type 1 or 2 diabetes abnormal liver, kidney or thyroid function large alcohol intake (women >16, men > 24 doses (4cl liquor or equivalent) during week) inflammatory bowel disease disease that prevents participation neuroleptic neuroleptic cortisone medication
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Matti IJ Uusitupa, professor, rector
Organizational Affiliation
University of Kuopio, Department of Clinical Nutrition
Official's Role
Study Director
Facility Information:
Facility Name
University of Kuopio, Department of Clinical Nutrition
City
Kuopio
ZIP/Postal Code
70211
Country
Finland

12. IPD Sharing Statement

Citations:
PubMed Identifier
30256894
Citation
Karkkainen O, Lankinen MA, Vitale M, Jokkala J, Leppanen J, Koistinen V, Lehtonen M, Giacco R, Rosa-Sibakov N, Micard V, Rivellese AAA, Schwab U, Mykkanen H, Uusitupa M, Kolehmainen M, Riccardi G, Poutanen K, Auriola S, Hanhineva K. Diets rich in whole grains increase betainized compounds associated with glucose metabolism. Am J Clin Nutr. 2018 Nov 1;108(5):971-979. doi: 10.1093/ajcn/nqy169.
Results Reference
derived
PubMed Identifier
25874636
Citation
Lankinen MA, Hanhineva K, Kolehmainen M, Lehtonen M, Auriola S, Mykkanen H, Poutanen K, Schwab U, Uusitupa M. CMPF does not associate with impaired glucose metabolism in individuals with features of metabolic syndrome. PLoS One. 2015 Apr 15;10(4):e0124379. doi: 10.1371/journal.pone.0124379. eCollection 2015.
Results Reference
derived
PubMed Identifier
25527657
Citation
Hanhineva K, Lankinen MA, Pedret A, Schwab U, Kolehmainen M, Paananen J, de Mello V, Sola R, Lehtonen M, Poutanen K, Uusitupa M, Mykkanen H. Nontargeted metabolite profiling discriminates diet-specific biomarkers for consumption of whole grains, fatty fish, and bilberries in a randomized controlled trial. J Nutr. 2015 Jan;145(1):7-17. doi: 10.3945/jn.114.196840. Epub 2014 Nov 12.
Results Reference
derived
PubMed Identifier
24587337
Citation
Lankinen M, Kolehmainen M, Jaaskelainen T, Paananen J, Joukamo L, Kangas AJ, Soininen P, Poutanen K, Mykkanen H, Gylling H, Oresic M, Jauhiainen M, Ala-Korpela M, Uusitupa M, Schwab U. Effects of whole grain, fish and bilberries on serum metabolic profile and lipid transfer protein activities: a randomized trial (Sysdimet). PLoS One. 2014 Feb 28;9(2):e90352. doi: 10.1371/journal.pone.0090352. eCollection 2014.
Results Reference
derived
PubMed Identifier
23514765
Citation
Lappi J, Salojarvi J, Kolehmainen M, Mykkanen H, Poutanen K, de Vos WM, Salonen A. Intake of whole-grain and fiber-rich rye bread versus refined wheat bread does not differentiate intestinal microbiota composition in Finnish adults with metabolic syndrome. J Nutr. 2013 May;143(5):648-55. doi: 10.3945/jn.112.172668. Epub 2013 Mar 20.
Results Reference
derived
PubMed Identifier
21901116
Citation
Lankinen M, Schwab U, Kolehmainen M, Paananen J, Poutanen K, Mykkanen H, Seppanen-Laakso T, Gylling H, Uusitupa M, Oresic M. Whole grain products, fish and bilberries alter glucose and lipid metabolism in a randomized, controlled trial: the Sysdimet study. PLoS One. 2011;6(8):e22646. doi: 10.1371/journal.pone.0022646. Epub 2011 Aug 25.
Results Reference
derived
PubMed Identifier
21870174
Citation
de Mello VD, Schwab U, Kolehmainen M, Koenig W, Siloaho M, Poutanen K, Mykkanen H, Uusitupa M. A diet high in fatty fish, bilberries and wholegrain products improves markers of endothelial function and inflammation in individuals with impaired glucose metabolism in a randomised controlled trial: the Sysdimet study. Diabetologia. 2011 Nov;54(11):2755-67. doi: 10.1007/s00125-011-2285-3. Epub 2011 Aug 26.
Results Reference
derived

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Dietary Modulation of Gene Expression and Metabolic Pathways in Glucose Metabolism

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