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Effects of Acipimox on Mitochondrial Function in Obesity

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ClinicalTrials.gov Identifier: NCT01488409
Recruitment Status : Completed
First Posted : December 8, 2011
Results First Posted : February 3, 2016
Last Update Posted : March 1, 2016
Sponsor:
Collaborator:
Information provided by (Responsible Party):

Study Description
Brief Summary:

The purpose of the study is to examine whether a medication called acipimox can improve your body's mitochondria. Mitochondria are the "power house" of the cell and make energy for your body.

Obesity is associated with increased risk for developing diabetes. However, the investigators do not know how obesity leads to diabetes. Previous studies have shown levels of fat in the blood (free fatty acids or FFA) are higher in obesity, and elevated FFA can affect how our body uses glucose and responds to insulin. Recent studies have shown that changes in mitochondria may be involved in the development of diabetes and may be affected by FFA. The investigators propose to improve the function of mitochondria in obese people with pre-diabetes by treating with acipimox, a medication which decreases FFA. The investigators will use state of the art techniques to evaluate the mitochondria, including a new magnetic resonance imaging (MRI) technique to measure function of mitochondria in muscle.


Condition or disease Intervention/treatment Phase
Abdominal Obesity Insulin Resistance Hypertriglyceridemia Drug: Acipimox Drug: Placebo Phase 2

Study Design

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 39 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: The Effects of Short Term Acipimox Treatment on Skeletal Muscle Phosphocreatine Recovery in Obesity
Study Start Date : May 2012
Primary Completion Date : January 2015
Study Completion Date : January 2015
Arms and Interventions

Arm Intervention/treatment
Experimental: Acipimox
Treatment with the study drug Acipimox
Drug: Acipimox
250 mg by mouth (PO) three times daily
Placebo Comparator: Placebo
Treatment with Placebo control.
Drug: Placebo
0 mg by mouth (PO) three times daily


Outcome Measures

Primary Outcome Measures :
  1. Change From Baseline in Phosphocreatine Recovery (ViPCr) at 6-months [ Time Frame: Change from Baseline to 6-months Visit ]
    The rate of recovery of phosphocreatine concentration after depletion by exercise is considered a measurement of mitochondrial function. Change in phosphocreatine recovery from baseline to 6 months will therefore give a measurement of change in mitochondrial function. ViPCR is given -- a higher value indicates better mitochondrial function.


Secondary Outcome Measures :
  1. Change From Baseline in Insulin Sensitivity at 6-months [ Time Frame: Change from Baseline to 6-months visit ]
    Change in insulin resistance assessed by hyperinsulinemic-euglycemic clamp study at Baseline and at 6-months. Change in insulin-stimulated glucose uptake (M) during 40 mU/m2/min insulin clamp is given.

  2. Change From Baseline in Mitochondrial Density at 6 Months [ Time Frame: Change from Baseline to 6-months ]
    Muscle tissue obtained from biopsy will be used to assess mitochondrial number and morphology by microscopes at Baseline and at 6-months. The change in mitochondrial density from 6 months to baseline is given.

  3. Change From Baseline in Intramyocellular Lipid Content at 6-months [ Time Frame: Change from Baseline to 6-months ]
    Change in tibialis intramyocellular lipid (IMCL) normalized to creatinine is given.

  4. Change From Baseline in Lipid Profile at 6-months [ Time Frame: Change from Baseline to 6-months ]
    Change in direct low density lipoprotein (LDL) cholesterol is given


Eligibility Criteria

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Ages Eligible for Study:   18 Years to 55 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Men and women age 18-55 years old
  2. Body Mass Index (BMI) ≥ 30 kg/m2
  3. Waist circumference ≥ 102 cm in men and ≥ 88 cm in women
  4. Hypertriglyceridemia defined as triglycerides ≥ 150 mg/dl OR Insulin resistance defined as elevated fasting glucose (≥ 100 mg/dl but <125 mg/dl) or hyperinsulinemia defined as fasting serum insulin ≥ 10 uU/ml.

Exclusion Criteria:

  1. Subjects on any hormonal treatment including estrogen, hormone replacement therapy, oral contraceptives, testosterone, glucocorticoids, anabolic steroids, GH, GH releasing hormone or Insulin like growth factor (IGF)-1 within 3months of enrollment.
  2. Subjects who have a known history of diabetes, using any anti-diabetic drugs, or fasting blood glucose of ≥ 125 mg/dl.
  3. Use of cholesterol lowering medication including niacin or fish oil.
  4. Changes in anti-hypertensive regimen within 3months of screening.
  5. Chronic illness including HIV, anemia (Hgb <12 g/dL), chronic kidney disease (Creatinine > 2 mg/dL), or liver disease (SGOT > 2.5 x upper limit normal).
  6. Use of Aspirin, Clopidogrel (Plavix), Warfarin (Coumadin) or other anti-coagulants
  7. History of or active peptic ulcer disease
  8. History of any recent cardiovascular event including myocardial infarction (MI; heart attack), cerebral vascular accident (CVA; or stroke) or transient ischemic attack (TIA; or mini-stroke) within 3 months of screening visit, unstable angina pectoris, oxygen-dependent severe pulmonary disease
  9. Subjects with contraindication for an MRI study including any significant metal in their body including surgical clippings, or pacemakers and known claustrophobia.
  10. History of recent alcohol or substance abuse (< 1 year)
  11. Positive pregnancy test or lactating females
  12. Women of child-bearing potential not currently using non-hormonal birth control methods including barrier methods (intra-uterine device or IUD, condoms, diaphragms) or abstinence
  13. Subject is currently enrolled in another investigational device or drug trial(s), or subject has received other investigational agent(s) within 28 days of baseline visit.
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01488409


Locations
United States, Massachusetts
Massachusetts General Hospital
Boston, Massachusetts, United States, 02114
Sponsors and Collaborators
Massachusetts General Hospital
American Diabetes Association
Investigators
Principal Investigator: Steven Grinspoon, MD Massachusetts General Hospital
More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Steven K. Grinspoon, MD, Professor of Medicine, Massachusetts General Hospital
ClinicalTrials.gov Identifier: NCT01488409     History of Changes
Other Study ID Numbers: 2011-P-000175
First Posted: December 8, 2011    Key Record Dates
Results First Posted: February 3, 2016
Last Update Posted: March 1, 2016
Last Verified: February 2016

Additional relevant MeSH terms:
Obesity
Insulin Resistance
Hypertriglyceridemia
Obesity, Abdominal
Overnutrition
Nutrition Disorders
Overweight
Body Weight
Signs and Symptoms
Hyperinsulinism
Glucose Metabolism Disorders
Metabolic Diseases
Hyperlipidemias
Dyslipidemias
Lipid Metabolism Disorders
Acipimox
Hypolipidemic Agents
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Lipid Regulating Agents