Brain Clock and Insulin Resistance

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Status: Completed

Conditions: Insulin Resistance; Type 2 Diabetes

Treatments: Device: functional MRI

Study type: Observational

Funder types: Other

Identifiers

NCT05314855

NL79698.018.21

Details and patient eligibility

About

In this observational cohort study the investigators will determine the activity rhythm of the suprachiasmatic nucleus in humans with progressive stages of insulin resistance, using advanced functional brain imaging (7 Tesla functional MRI).

Full description

Type 2 diabetes mellitus (T2DM) has an increasing worldwide incidence. Insulin resistance is a key pathophysiological process in the development of hyperglycemia in patients with T2DM. Disruption of circadian synchrony leads to insulin resistance. Animal studies and post-mortem human brain studies suggest that the master brain clock in the hypothalamic suprachiasmatic nucleus (SCN) plays a role in the development of insulin resistance. Up to now, no-one has investigated whether the in vivo activity rhythm of the SCN is affected in patients with insulin resistance. The investigators hypothesize that the master brain clock has an important role in the development of human insulin resistance.

Enrollment: 28 patients

Sex: All

Ages: 25 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

Group 1: obese people with normal insulin sensitivity

• age 25-65 years
• BMI>30
• fasting plasma insulin ≤62 pmol/L
• fasting plasma glucose <5.6 mmol/L
• Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) ≤ 4.5

Group 2: obese people with insulin resistance

• age 25-65 years
• BMI>30
• fasting plasma insulin >62 pmol/L
• not fulfilling the American Diabetes Association (ADA) criteria for type 2 DM

Group 3: obese subjects with overt type 2 DM

• age 25-65 years
• BMI>30
• diagnosis type 2 DM according to ADA criteria

Exclusion criteria

• An extreme chronotype (midpoint of sleep on free days (MSFsc) before 2:00 or after 6:00).
• Active psychiatric disorder (including circadian rhythm sleep disorder) as defined in Diagnostic and Statistical Manual of Mental Disorders (DSM) 5
• Disorders of the central nervous system (Early-onset dementia, stroke, epilepsy, Parkinson's disease, brain tumor)
• Severe visual impairment (WHO classification)
• Shift workers
• Crossing > 2 time zones in the 3 months before the study
• Patients with type 2 DM receiving insulin treatment or glucagon-like peptide (GLP) 1 agonists
• MRI contraindications

Trial design

28 participants in 3 patient groups

Obese individuals with normal insulin sensitivity

Treatment:

Device: functional MRI

Obese individuals with impaired insulin sensitivity

Treatment:

Device: functional MRI

Obese patients with type 2 diabetes

Treatment:

Device: functional MRI