Insulin and Sarcopenia in the Elderly

The recruitment status of this study is unknown because the information has not been verified recently.
Verified May 2012 by The University of Texas, Galveston.
Recruitment status was  Recruiting
Sponsor:
Information provided by (Responsible Party):
The University of Texas, Galveston
ClinicalTrials.gov Identifier:
NCT00690534
First received: May 27, 2008
Last updated: May 3, 2012
Last verified: May 2012

May 27, 2008
May 3, 2012
September 2005
August 2012   (final data collection date for primary outcome measure)
muscle protein synthesis [ Time Frame: 5 and 8 hours ] [ Designated as safety issue: No ]
Same as current
Complete list of historical versions of study NCT00690534 on ClinicalTrials.gov Archive Site
blood flow [ Time Frame: 5 and 8 hours ] [ Designated as safety issue: No ]
Same as current
Not Provided
Not Provided
 
Insulin and Sarcopenia in the Elderly
Insulin and Sarcopenia in the Elderly

Muscle loss with aging is a significant contributor to disability in older people. Our general hypothesis is that loss of muscle with aging, known as sarcopenia, may be due to inability of muscle to grow in response to insulin. Our goal is to determine the mechanisms underlying this age-related insulin resistance of muscle proteins, which will allow us to define in the future specific interventions to target this defect and provide the scientific basis for the prevention and treatment of sarcopenia.

Our general hypothesis is that a reduced response of muscle protein anabolism to insulin plays an important role in the loss of muscle mass with aging. Our goal is to determine the mechanisms underlying the age-related insulin resistance of muscle proteins, which will allow us to define specific interventions to target this defect and provide the scientific basis for the prevention and treatment of sarcopenia.

Our previous studies indicate that the response of muscle proteins to the anabolic action of insulin is impaired in healthy older adults as compared to younger controls, which hampers the anabolic effect of mixed feeding on muscle proteins. These changes are associated with an age-related reduction in the vasodilatory response to insulin, which, from our data, appears to be a potentially important mediator of the physiological anabolic effect of insulin on muscle proteins. Preliminary data from our laboratory also suggest that in older subjects a single bout of aerobic exercise may restore the normal response of blood flow, muscle protein synthesis and anabolism to insulin.

Therefore, we will test in healthy subjects the following specific hypotheses:

  1. Insulin-induced increases in blood flow and muscle perfusion are necessary for the physiological stimulation of muscle protein synthesis and anabolism by insulin.
  2. Aging reduces the vascular sensitivity to insulin, which prevents the physiological increase in blood flow and muscle perfusion in response to insulin, thereby decreasing the response of muscle protein synthesis and net balance to the anabolic action of insulin and mixed feeding.
  3. Aerobic exercise can restore, in older subjects, the insulin-induced increase in blood flow and muscle perfusion to youthful levels, thus normalizing the anabolic effect of insulin and mixed feeding on muscle protein synthesis and net muscle protein balance.

We will use state-of the art stable isotope tracer techniques to measure muscle protein turnover, and a newly developed method to measure muscle perfusion in young and older subjects. The results of these studies will allow us to better define the physiological mechanisms of action of insulin on muscle protein anabolism, advance our knowledge on the pathophysiology of sarcopenia, and provide the scientific basis for the behavioral and/or pharmacological treatment of muscle loss with aging.

Interventional
Not Provided
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Basic Science
Sarcopenia
  • Drug: Insulin Regular
    insulin, 0.2 mU/kg/min for 3 hours
  • Drug: L-NMMA
    variable rate for 3 hours
  • Drug: Sodium Nitroprusside
    variable rate for 3 hours
  • Other: mixed meal
    mixed meal
  • Active Comparator: CMAY
    Insulin in young
    Intervention: Drug: Insulin Regular
  • Experimental: IMAY
    L-NMMA + insulin in young
    Interventions:
    • Drug: Insulin Regular
    • Drug: L-NMMA
  • Experimental: SNPY
    SNP in young
    Intervention: Drug: Sodium Nitroprusside
  • Active Comparator: CSNP
    Insulin in elderly
    Intervention: Drug: Insulin Regular
  • Experimental: ISNP
    SNP in elderly
    Interventions:
    • Drug: Insulin Regular
    • Drug: Sodium Nitroprusside
  • Experimental: SNPE
    SNP in elderly
    Intervention: Drug: Sodium Nitroprusside
  • Active Comparator: CMealO
    Meal in elderly
    Intervention: Other: mixed meal
  • Experimental: SMealO
    SNP+meal in elderly
    Interventions:
    • Drug: Sodium Nitroprusside
    • Other: mixed meal
  • Active Comparator: MealY
    meal in young
    Intervention: Other: mixed meal
  • Experimental: ExIns
    insulin+exercise in elderly
    Intervention: Drug: Insulin Regular
  • Experimental: ExMeal
    meal+exercise in elderly
    Intervention: Other: mixed meal

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
88
August 2012
August 2012   (final data collection date for primary outcome measure)

Inclusion Criteria:

  1. Age 18-40 yrs, and 65-85 yrs.
  2. Ability to sign consent form (score >23 on the 30-item Mini Mental State Examination, MMSE)
  3. Stable body weight for at least 3 months

Exclusion Criteria:

  1. Physical dependence or frailty (impairment in any of the Activities of Daily Living (ADL), history of falls (>2/year) or significant weight loss in the past year)
  2. Exercise training (>2 weekly sessions of moderate to high intensity aerobic or resistance exercise)
  3. Pregnancy or nursing women.
  4. Significant heart, liver, kidney, blood or respiratory disease
  5. Peripheral vascular disease
  6. Diabetes mellitus or other untreated endocrine disease
  7. Active cancer
  8. Recent (within 6 months) treatment with anabolic steroids, or corticosteroids.
  9. Alcohol or drug abuse
  10. Severe depression (>5 on the 15-item Geriatric Depression Scale, GDS)
  11. Potential subjects who have recently donated blood in the past 60 days will be excluded from participating in the study.
Both
18 Years to 85 Years
Yes
Contact: Elena Volpi, MD, PhD 409-772-1977 evolpi@utmb.edu
Contact: Shaheen Dhanani, MD 409-747-3559 shdhanan@UTMB.EDU
United States
 
NCT00690534
05-090, R01 AG18311
No
The University of Texas, Galveston
The University of Texas, Galveston
Not Provided
Principal Investigator: Elena Volpi, MD, PhD The University of Texas Medical Branch at Galveston
The University of Texas, Galveston
May 2012

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP