Investigating Whether Acute Elevation of Fatty Acid Levels Alters Cerebral Glucose Transport and Metabolism

University of North Carolina (UNC)

Status and phase: Enrolling; Phase 2; Phase 1

Conditions: Obesity

Treatments: Drug: Placebos; Drug: Intralipid, 20% Intravenous Emulsion

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04328337

22-2455

1R01DK123227-01 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The goal of this study is to understand the role of brain glucose transport in individuals with obesity and the association with cerebral hypometabolism and these individuals' response to plasma glucose elevations. The main premise is that obesity leads to reduced brain glucose transport and that we can measure this reduction with magnetic resonance spectroscopy (MRS). The secondary premises are that this reduction is driven by elevated non esterified fatty acids which act to turn on specific signaling pathways that regulate brain GLUT1 levels.

Full description

There are 2 aims of this study. The intent of aim 1 is to measure the effect of obesity on glucose transport and metabolism in the human brain. This study aim will be conducted in non-diabetic, obese individuals and age- and HbA1c-matched normal weight individuals. A total of 15 non-diabetic - normal weight individuals and 15 obese individuals will be enrolled.

The second aim randomizes 40 non-diabetic, normal weight individuals. The intent of aim 2 is to determine whether acute elevation of NEFA levels in lean, healthy individuals will alter cerebral glucose transport. Eligible participants will be randomized (1:1) to receive either intralipid or normal saline.

The focus of this protocol registration is the randomized portion of the study (aim 2).

Enrollment: 40 estimated patients

Sex: All

Ages: 18 to 45 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Age 18-45 years
• HbA1C <6.5%
• Normal weight individuals: BMI 17-25 kg/m^2
• Obese individuals: BMI >30 kg/m^2

Exclusion criteria

• Creatinine >1.5mg/dL
• Hematocrit <35% for females and <39% for males
• ALT and AST >2.5X upper limit of normal
• Abnormal TSH
• Abnormal PT/PTT/INR
• Triglycerides >200 mg/dL
• Known hepatic, gastrointestinal, renal, neurologic, psychiatric, cerebrovascular disease
• Uncontrolled hypertension
• Current or past 3 months use of ketogenic diet
• Use of any medications, vitamins, or supplements that can alter cerebral metabolism or lipids
• Smoking
• Current or recent steroid use in last 6 months
• >5% body weight change in last 6 months
• Illicit drug use/alcoholism
• Inability to enter MRI/MRS
• For women: pregnancy, seeking pregnancy, or breastfeeding

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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40 participants in 2 patient groups, including a placebo group

Non-diabetic, normal weight individuals receiving Intralipid

Experimental group

Description:

Non-diabetic, normal weight individuals receiving Intralipid. Participants will receive an infusion of Intralipid 20% for 12 hours through an IV (prior to and during scan #2)

Treatment:

Drug: Intralipid, 20% Intravenous Emulsion

Non-diabetic, normal weight individuals receiving saline

Placebo Comparator group

Description:

Non-diabetic, normal weight individuals receiving saline. Participants will receive an infusion of normal saline (1:1 randomization) at 30 ml/hr for 12 hours through an IV (prior to and during scan #2

Treatment:

Drug: Placebos