Metabolic Actions of Omega-3 Fatty Acids
Primary Purpose
Metabolic Syndrome
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
EPA (marine fatty acids)
Placebo
Sponsored by
About this trial
This is an interventional prevention trial for Metabolic Syndrome focused on measuring Metabolic Syndrome, Omega 3 Fish Oil
Eligibility Criteria
Inclusion Criteria:
Metabolic Syndrome, including 2 of the following:
- Treated Hyperlipidemia or Untreated Triglycerides > 150 mg/dL
- Waist circumference (inches) > 35 (women) or >40 (men)
- And at least 1 additional factor:
- Treated Hypertension or Untreated Blood pressure >130/85 and < 160/100 mm Hg
- HDL-C < 40 mg/dL men < 50 mg/dL women
- Glucose > 100mg/dL and HbA1c < 6.1%
Exclusion Criteria:
- Fasting TG > 500 mg/dL or LDL > 180 mg/dL
- Fasting glucose> 125 mg/dL or history of diabetes mellitus
- Hematologic or malignant disorders
- Morbid Obesity (BMI > 50 kg/m2)
- Endocrine (thyroid) or metabolic disorders (unless treated and under control)
- Alcohol consumption greater than (2) 4-ounce glasses of table wine, (2) 12-oz bottles of beer or 2 shots of spirits in men or women
- Active IV drug abuse within the past 6 months
- Clinical depression (per PI evaluation)
- Immunosuppressive or other therapy that would interfere with research testing
Sites / Locations
- University of Maryland Medical Center
- Amish Research Center
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
EPA (marine fatty acids)
Placebo
Arm Description
Subjects will receive EPA , four 1 gram capsules daily.
Subjects will be randomized to receive placebo, four 1 gram capsules daily.
Outcomes
Primary Outcome Measures
Biochemical measurements of lipids, glucose homeostasis, inflammatory markers, and adipocyte responses to mediators of lipolysis
Metabolic (e.g., lipoproteins, inflammatory cytokines, acute phase reactants, glucose tolerance/insulin resistance) and adipose tissue responses (basal and insulin suppression of lipolysis (ED50), LPL activity, cytokine release and lipogenesis).
Secondary Outcome Measures
Determination of regional fat distribution, visceral and subcutaneous adipose volume and body composition
Regional fat distribution quantified anthropometrically as waist and hip circumference, visceral and subcutaneous adipose volumes and muscle lipid accumulation by CT-scan and body composition (total and regional fat mass) by dual energy absorptiometry (DXA).
Full Information
NCT ID
NCT01896414
First Posted
June 18, 2013
Last Updated
January 10, 2020
Sponsor
University of Maryland, Baltimore
Collaborators
National Institutes of Health (NIH), US Department of Veterans Affairs, National Heart, Lung, and Blood Institute (NHLBI)
1. Study Identification
Unique Protocol Identification Number
NCT01896414
Brief Title
Metabolic Actions of Omega-3 Fatty Acids
Official Title
Metabolic Actions of Omega-3 Fatty Acids on Inflammation and Adipocyte Lipolysis in the Metabolic Syndrome
Study Type
Interventional
2. Study Status
Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
July 2014 (undefined)
Primary Completion Date
May 30, 2016 (Actual)
Study Completion Date
May 30, 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Maryland, Baltimore
Collaborators
National Institutes of Health (NIH), US Department of Veterans Affairs, National Heart, Lung, and Blood Institute (NHLBI)
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The metabolic syndrome raises the risk of heart disease and is currently at epidemic proportions in the U.S. It consists of 3 of the following components: central obesity, high triglycerides, low HDL, abnormal blood pressure and impaired fasting glucose levels. Previous studies have suggested that omega-3 fish oil may influence some of these components but the mechanisms involved are not well understood. Therefore, this proposal will investigate how omega-3 fish oils affect inflammation, lipids and fat breakdown by comparing it to placebo. Favorable outcomes from this study could translate into a new approach to improve heart disease risk in men and women with the metabolic syndrome.
Detailed Description
Metabolic Actions of Omega-3 Fatty Acids on Inflammation and Adipocyte Lipolysis in the Metabolic Syndrome
Epidemiological studies identify metabolic syndrome (MetS) as a biomarker of cardiovascular disease (CVD) risk, and recent AHA scientific statements recommend intensive lifestyle diet and exercise measures to reduce risk. Marine-derived omega-3 polyunsaturated fatty acids such as, eicosapentanoic acid (EPA) improve many constituents of the metabolic syndrome such as lowering fasting TG and glucose levels, inflammation, insulin resistance and blood pressure. These improvements may be mediated by increased fat cell storage and metabolism and lipids, reducing inflammation and ectopic fat deposition in visceral abdominal tissue, muscle and liver that results in excessive pro-inflammatory intra-abdominal fat (IAF), insulin resistance and reduced levels of HDL cholesterol, hallmark characteristics of the MetS. The anti-inflammatory actions of EPA lower acute phase reactants (APRs) and proinflammatory mediators are mechanisms for their lipid lowering and insulin sensitizing effects to reduce CVD risk. The systematic investigation of marine-derived omega-3 PUFAs on these inflammatory, metabolic and physiological parameters will provide new mechanistic insights for the therapeutic use of a potentially beneficial, safe nutraceutical, EPA in patients with MetS. Thus, it is our hypothesis that supplementation of marine-derived omega-3 PUFAs, will reduce constituents of MetS as well as systemic and tissue inflammation, insulin resistance (HOMA-IR), adipocyte lipolysis and cytokine release from AT to enhance TG storage capacity of subcutaneous AT. The reduction in inflammation and increase in insulin sensitivity will remodel adipose tissue to function more efficiently in TG uptake and storage; thus, reducing circulating FFAs and cytokines. We postulate that these metabolic effects may decrease ectopic fat deposition in viscera (IAF and muscle), an intriguing, novel outcome that provides rationale for the 9 month treatment.
The Specific Aims are to conduct a pilot 9 month randomized trial in adults with high Tg and at least one other component of the MetS to compare the effects of EPA vs. placebo on:
Aim 1: Metabolic (e.g., lipoproteins, inflammatory cytokines, acute phase reactants, glucose tolerance/insulin resistance) and adipose tissue responses (basal and insulin suppression of lipolysis (ED50), LPL activity, cytokine release and lipogenesis).
Aim 2: Regional fat distribution quantified anthropometrically as waist and hip circumference, visceral and subcutaneous adipose volumes and muscle lipid accumulation by CT-scan and body composition (total and regional fat mass) by dual energy absorptiometry (DXA).
These outcomes have potentially intriguing therapeutic implications for marine derived omega-3 PUFA supplementation as part of a lifestyle program for patients at increased cardiometabolic risk.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metabolic Syndrome
Keywords
Metabolic Syndrome, Omega 3 Fish Oil
7. Study Design
Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
40 (Actual)
8. Arms, Groups, and Interventions
Arm Title
EPA (marine fatty acids)
Arm Type
Experimental
Arm Description
Subjects will receive EPA , four 1 gram capsules daily.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Subjects will be randomized to receive placebo, four 1 gram capsules daily.
Intervention Type
Dietary Supplement
Intervention Name(s)
EPA (marine fatty acids)
Intervention Description
Subjects will be randomized to receive either EPA or placebo, four 1 gram capsules daily.
Intervention Type
Dietary Supplement
Intervention Name(s)
Placebo
Intervention Description
Subjects will be randomized to receive either EPA/ or placebo, four 1 gram capsules daily.
Primary Outcome Measure Information:
Title
Biochemical measurements of lipids, glucose homeostasis, inflammatory markers, and adipocyte responses to mediators of lipolysis
Description
Metabolic (e.g., lipoproteins, inflammatory cytokines, acute phase reactants, glucose tolerance/insulin resistance) and adipose tissue responses (basal and insulin suppression of lipolysis (ED50), LPL activity, cytokine release and lipogenesis).
Time Frame
Up to 2 years
Secondary Outcome Measure Information:
Title
Determination of regional fat distribution, visceral and subcutaneous adipose volume and body composition
Description
Regional fat distribution quantified anthropometrically as waist and hip circumference, visceral and subcutaneous adipose volumes and muscle lipid accumulation by CT-scan and body composition (total and regional fat mass) by dual energy absorptiometry (DXA).
Time Frame
Up to 2 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
25 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Metabolic Syndrome, including 2 of the following:
Treated Hyperlipidemia or Untreated Triglycerides > 150 mg/dL
Waist circumference (inches) > 35 (women) or >40 (men)
And at least 1 additional factor:
Treated Hypertension or Untreated Blood pressure >130/85 and < 160/100 mm Hg
HDL-C < 40 mg/dL men < 50 mg/dL women
Glucose > 100mg/dL and HbA1c < 6.1%
Exclusion Criteria:
Fasting TG > 500 mg/dL or LDL > 180 mg/dL
Fasting glucose> 125 mg/dL or history of diabetes mellitus
Hematologic or malignant disorders
Morbid Obesity (BMI > 50 kg/m2)
Endocrine (thyroid) or metabolic disorders (unless treated and under control)
Alcohol consumption greater than (2) 4-ounce glasses of table wine, (2) 12-oz bottles of beer or 2 shots of spirits in men or women
Active IV drug abuse within the past 6 months
Clinical depression (per PI evaluation)
Immunosuppressive or other therapy that would interfere with research testing
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Miller, M.D.
Organizational Affiliation
University of Maryland, College Park
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Maryland Medical Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
Amish Research Center
City
Lancaster
State/Province
Pennsylvania
ZIP/Postal Code
17601
Country
United States
12. IPD Sharing Statement
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Metabolic Actions of Omega-3 Fatty Acids
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