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Metabolic Adaptations to Weight Loss With and Without Exercise (WAX)

Primary Purpose

Obesity, Metabolic Disease, Metabolic Syndrome

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
MICT Exercise
No Exercise (Control)
Sponsored by
University of Michigan
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Obesity

Eligibility Criteria

18 Years - 40 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion criteria Age: 18-40 Body Mass Index: 30-40 kg/m2 Weight stable (±3kg for greater than or equal to about 2 months) No regularly planned exercise/physical activity Women must have regularly occurring menses and must be premenopausal Exclusion criteria EKG abnormalities Evidence/history of cardiovascular disease, diabetes or other metabolic disease Medications known to affect lipid or glucose metabolism Pregnant or lactating Tobacco or e-cigarette use Prior experience of hypersensitivity to insulin, human albumin, and potassium chloride injection. Allergies/hypersensitivity to local anesthetics of the amide type (e.g., lidocaine) History of hyperkalemia or potential for developing hyperkalemia (including but not limited to taking drugs that may induce hyperkalemia such as cardiac glycosides or potassium sparing diuretics) Anti-coagulant medication (e.g., Coumadin, Rivaroxaban) and Lidocaine allergy/sensitivity are exclusion criteria for the biopsy procedure.

Sites / Locations

  • University of MichiganRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Moderate Intensity Continuous Training (MICT) exercise group

No exercise (Control)

Arm Description

45 minutes of continuous steady-state exercise at 70% maximal heart rate throughout the 10% weight loss phase of the study

to remain sedentary (no planned physical exercise) throughout the duration of the 10% weight loss phase of the study

Outcomes

Primary Outcome Measures

Insulin sensitivity
a hyperinsulinemic-euglycemic clamp will be used to quantify peripheral insulin sensitivity
Fatty acid turnover
stable isotope tracer infusion methods will be used to assess fatty acid turnover
Adipose tissue capillarization
measured immunohistochemically using an antibody for CD31, quantified using ImageJ software
Adipose tissue fibrosis
measured histologically using Sirus Red Staining, quantified using ImageJ software

Secondary Outcome Measures

Body weight change
Change in body weight will be assessed 6 months after completing the 10% weight loss intervention
Body fat mass
Body fat mass will be measured by Dual Energy X-ray Absorptiometry (DEXA)
Oral Glucose Tolerance Test (OGTT)
A test in which glucose is given and blood samples taken afterward to determine how quickly it is cleared from the blood will be completed at each clinical visit appointment

Full Information

First Posted
March 28, 2023
Last Updated
August 19, 2023
Sponsor
University of Michigan
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1. Study Identification

Unique Protocol Identification Number
NCT05806801
Brief Title
Metabolic Adaptations to Weight Loss With and Without Exercise
Acronym
WAX
Official Title
Metabolic Adaptations to Weight Loss With and Without Exercise
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 19, 2023 (Actual)
Primary Completion Date
August 1, 2027 (Anticipated)
Study Completion Date
May 31, 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Michigan

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Study Purpose: The combination of caloric restriction and exercise is the most common first-line treatment for obesity-related disorders, yet we know very little about how these two very different treatments work together. A deeper understanding about mechanisms underlying the health benefits of adding exercise to a weight loss program will not only aid efforts to optimize more effective lifestyle interventions, but it can also uncover novel targets for the treatment/prevention of obesity-related diseases. Although a reduction in body fat is the fundamental adaptation to weight loss, we know almost nothing about the effects that adding exercise has on structural and functional changes within fat tissue that may further enhance metabolic health. This is very important because many obesity-related metabolic health complications are tightly linked with abnormalities in abdominal fat tissue. We argue exercise-induced modifications in abdominal fat tissue will reveal persistent health benefits even if some weight is regained Study Summary: 10% Weight Loss Phase - Subject participation in the study will involve a series of metabolic tests before, at midpoint, and after undergoing a 10% weight loss program (with or without exercise training depending on group randomization). During this, subjects will be randomized into one of two different experimental groups: Moderate Intensity Continuous Training (MICT) exercise group No exercise (control) group Follow-up Phase: After completing the metabolic testing post-weight loss, all study-related diet and exercise supervision will end and subjects will be free to make their own choices regarding diet and exercise/physical activity behavior. Subjects will then be asked to complete follow-up testing at 2-, 4- and 6- months post-weight loss. Total involvement in the study for each subject will likely be about 10-13 months (4-7 months during weight loss phase, 6 months during follow-up phase).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Obesity, Metabolic Disease, Metabolic Syndrome, Insulin Sensitivity, Insulin Resistance, Weight Loss

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
68 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Moderate Intensity Continuous Training (MICT) exercise group
Arm Type
Experimental
Arm Description
45 minutes of continuous steady-state exercise at 70% maximal heart rate throughout the 10% weight loss phase of the study
Arm Title
No exercise (Control)
Arm Type
Experimental
Arm Description
to remain sedentary (no planned physical exercise) throughout the duration of the 10% weight loss phase of the study
Intervention Type
Behavioral
Intervention Name(s)
MICT Exercise
Intervention Description
Subjects randomized into this group will complete a moderate intensity continuous exercise 4 days/week.
Intervention Type
Behavioral
Intervention Name(s)
No Exercise (Control)
Intervention Description
Subjects randomized into this group will remain sedentary throughout the duration of the study.
Primary Outcome Measure Information:
Title
Insulin sensitivity
Description
a hyperinsulinemic-euglycemic clamp will be used to quantify peripheral insulin sensitivity
Time Frame
2 hours
Title
Fatty acid turnover
Description
stable isotope tracer infusion methods will be used to assess fatty acid turnover
Time Frame
2 hours
Title
Adipose tissue capillarization
Description
measured immunohistochemically using an antibody for CD31, quantified using ImageJ software
Time Frame
30 minutes
Title
Adipose tissue fibrosis
Description
measured histologically using Sirus Red Staining, quantified using ImageJ software
Time Frame
30 minutes
Secondary Outcome Measure Information:
Title
Body weight change
Description
Change in body weight will be assessed 6 months after completing the 10% weight loss intervention
Time Frame
6 months
Title
Body fat mass
Description
Body fat mass will be measured by Dual Energy X-ray Absorptiometry (DEXA)
Time Frame
30 minutes
Title
Oral Glucose Tolerance Test (OGTT)
Description
A test in which glucose is given and blood samples taken afterward to determine how quickly it is cleared from the blood will be completed at each clinical visit appointment
Time Frame
2 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion criteria Age: 18-40 Body Mass Index: 30-40 kg/m2 Weight stable (±3kg for greater than or equal to about 2 months) No regularly planned exercise/physical activity Women must have regularly occurring menses and must be premenopausal Exclusion criteria EKG abnormalities Evidence/history of cardiovascular disease, diabetes or other metabolic disease Medications known to affect lipid or glucose metabolism Pregnant or lactating Tobacco or e-cigarette use Prior experience of hypersensitivity to insulin, human albumin, and potassium chloride injection. Allergies/hypersensitivity to local anesthetics of the amide type (e.g., lidocaine) History of hyperkalemia or potential for developing hyperkalemia (including but not limited to taking drugs that may induce hyperkalemia such as cardiac glycosides or potassium sparing diuretics) Anti-coagulant medication (e.g., Coumadin, Rivaroxaban) and Lidocaine allergy/sensitivity are exclusion criteria for the biopsy procedure.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Suzette M Howton
Phone
734-647-9850
Email
suzetter@med.umich.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jeffrey Horowitz, PhD
Organizational Affiliation
University of Michigan
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Suzette Howton
Phone
734-647-9850
Email
suzetter@med.umich.edu
First Name & Middle Initial & Last Name & Degree
Jeff F Horowitz, PhD

12. IPD Sharing Statement

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Metabolic Adaptations to Weight Loss With and Without Exercise

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