Hepatic and Cardiac Metabolic Flexibility in Obese With NAFLD.

University of Aarhus

Status

Completed

Conditions

NAFLD - Nonalcoholic Fatty Liver Disease

Treatments

Behavioral: Exercise

Study type

Interventional

Funder types

Other

Identifiers

NCT03583437

jeyanrk

Details and patient eligibility

About

Non-alcoholic fatty liver disease (NAFLD) covers a spectrum from reversible hepatic steatosis to inflammation and fibrosis termed steatohepatitis (NASH) and cirrhosis. New evidence indicates that NAFLD is associated with development of heart failure, abnormal ventricular glucose and fatty acid (FA) utilisation and cardiosteatosis. The mechanisms behind cardiac involvement and the progression from NAFLD to NASH are poorly understood but must include altered cardiac and intrahepatic lipid handling. In collaboration with renowned research groups from Oxford, Mayo Clinic and Copenhagen investigators plan comprehensive kinetic studies of heart and liver FA uptake and oxidation, ventricular function and substrate utilisation, and hepatic triglyceride (TG) secretion in order to assess mechanisms governing cardiac and hepatic lipid and glucose trafficking in subjects with NAFLD and NASH and the relationship with heart function. In addition, the investigators will assess skeletal muscle and adipose tissue enzyme activities, gene expression and protein concentrations in these subjects to define mechanisms involved in the cross-talk between heart, liver, muscle and adipose tissues. Investigators will address these questions using innovative tracer techniques (11Cpalmitate, 11C acetate, 18FDG glucose PET tracers and TG tracers) in combination with hepatic vein catherisation to study cardiac and liver substrate trafficking, as well as NMR spectroscopy, echocardiography, muscle and fat biopsies in combination with state-of-the art muscle and adipose tissue enzyme kinetics, gene- and protein expression. Effects of acute exercise will be assessed. The overarching goals are to define abnormalities and differences between NAFLD and NASH in hepatic lipid (FA and TG) metabolism and to assess the effect of exercise on both hepatic, cardiac and adipose and skeletal muscle lipid and substrate utilisation.

Enrollment

17 patients

Sex

All

Ages

40 to 70 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

10 obese subject men/women with NAFLD (MR spectroskopi, fibro scanner) (BMI > 30).
10 obese subject men/women without NAFLD (MR spectroskopi, fibro scanner) (BMI > 30).
age between 40-70 years
Written consent before the start of the study

Exclusion criteria

known current disease
Fixed Medical drug consumption, statins and antihypertensive drugs (non-beta blocker). However, pause 3 weeks before the examination date
Blood donation within the last 3 months prior to the study
Participation in experiments involving radioactive isotopes within the last 6 months
Alcohol abuse (over 21 items per week for men and 14 for women)
Smoking
Weight over 130 kg
Cancer patients
Large intake of medication