Dopamine and Insulin Resistance

Vanderbilt University

Status: Completed

Conditions: Obesity

Treatments: Behavioral: Psychological scales to assess attitudes and behaviors related to eating and quality of life; Radiation: PET scan; Other: Caloric Restriction; Procedure: MRI; Procedure: Oral glucose tolerance test

Study type: Interventional

Funder types: Other

Identifiers

NCT00802204

IRB#080861 and 061246

Details and patient eligibility

About

Obese individuals have fewer striatal dopamine type 2 receptors (DRD2) than normal weight individuals. Lower DRD2 levels are associated with addiction and a decreased sense of pleasure.Obesity is also associated with insulin resistance (poor insulin action).We propose that insulin resistance and low DRD2 are associated. Using PET imaging,we aim to determine DRD2 binding potential (BP) in the brain is associated with insulin resistance and neuroendocrine hormone levels. Obese participants will be compared to lean, gender and age similar participants. We also aim to determine the effect of caloric restriction on DRD2 BP in obese subjects

Full description

In has been reported obese individuals have fewer striatal dopamine type 2 receptors (DRD2) compared to normal weight individuals congruent with diet induced obese rodent models and similar to models of addiction. Lower DRD2 levels are associated with addiction and a decreased sense of pleasure. Excessive weight gain also contributes to the onset of impaired insulin signaling (insulin resistance). In the brain insulin regulates monoamines and has trophic effects. We propose that the previous reports of low DRD2 in individuals with obesity will be associated with the degree of insulin resistance. Using PET imaging, we aim to determine DRD2 binding potential (BP) in the striatum and hypothesize these measurements will be associated with insulin resistance and potentially other neuroendocrine hormone levels. Obese participants will be compared to lean, sex and age similar participants. We also aim to determine the effect of caloric restriction on DRD2 BP in obese subjects. We hypothesize the caloric restriction will improve insulin resistance and that changes in DRD2 binding will be associated with changes in insulin signaling.

Enrollment: 28 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Ages 18-60 yrs
• obese BMI > 30kg/m2 and Weight less than 350 lbs
• lean control BMI 18-25kg/m2

Exclusion criteria

• Structured exercise > equivalent to 30mins 5x week of walking times a week
• History of Substance Abuse, including but exclusive to alcohol, cocaine, marijuana, heroin, nicotine
• Current psychiatric disorder or significant h/o disorder
• Use or any antidepressants or antipsychotics for last 3-6months or depot antipsychotics in the last 12 months
• Any condition felt by PI or co-investigators to interfere with ability to complete the study
• Inability to abstain from alcohol, physical exercise or > 1 cup of coffee or equivalent daily for 3 days prior to imaging studies
• Significant co-morbidities including atherosclerotic disease, metabolic disease, liver or renal insufficiency or abnormality found on MRI
• Any condition which would interfere with MRI or PET studies, e.g. claustrophobia, cochlear implant, metal fragments in eyes, cardiac pacemaker, neural stimulator, tattoos with iron pigment and metallic body inclusions or other metal implanted in the body which may interfere with MRI scanning
• Subjects on medications determined by PI, ex. sibutramine, frequent benzodiazepines or related drugs, which could affect quality of study for last 3 months.

Trial design

Primary purpose: Other

Allocation: Non-Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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28 participants in 2 patient groups

Lean controls

Active Comparator group

Description:

Lean complete baseline outcome measures only

Treatment:

Radiation: PET scan

Behavioral: Psychological scales to assess attitudes and behaviors related to eating and quality of life

Procedure: Oral glucose tolerance test

Procedure: MRI

Obese

Experimental group

Description:

Obese completing baseline and post-VLCD outcome measures

Treatment:

Radiation: PET scan

Behavioral: Psychological scales to assess attitudes and behaviors related to eating and quality of life

Procedure: Oral glucose tolerance test

Procedure: MRI

Other: Caloric Restriction