Regulation of Muscle Protein Phenotype in Humans With Obesity

• ClinicalTrials.gov Identifier: NCT04700800
• Recruitment Status: Recruiting
• First Posted: January 8, 2021
• Last Update Posted: January 28, 2022
• Sponsor: Mayo Clinic
• Collaborator: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
• Information provided by (Responsible Party): Lori R. Roust, Mayo Clinic

Study Description

Brief Summary:

Maintenance of protein homeostasis is impaired in skeletal muscle of humans with obesity. A hallmark of this defect is distorted expression of isoforms of the myosin heavy chain (MHC) protein, and this defect is linked to obesity-associated adverse health outcomes. By employing exercise and increase in plasma amino acids as investigational tools the investigators intend to modulate the metabolism of muscle MHC isoforms in order to unravel the biological mechanisms that sustain distorted MHC protein metabolism in muscle of humans with obesity.

Condition or disease	Intervention/treatment	Phase
Obesity	Other: Exercise; Other: Infusion of Amino Acids	Not Applicable

Detailed Description:

Distorted expression of isoforms of the skeletal muscle myosin heavy chain (MHC) protein is a hallmark of altered protein metabolism in muscle of humans with obesity. The most striking feature of this, is a characteristic reduction in the content of the slow MHC-I isoform, which is responsible for determining the content of Type I muscle fibers. These fibers are characterized by increased capacity for glucose uptake, and in contrast to Type II fibers, maintain sensitivity to fuel metabolism within the adverse metabolic environment of obesity. Increased content of Type I fibers in skeletal muscle, and thus favorable metabolic effects in muscle, require increased expression of MHC-I in muscle. Importantly, the slow MHC-I gene drives the molecular mechanisms that determine the overall MHC protein metabolism and fiber type phenotype in skeletal muscle. The project seeks to determine the underlying biology that sustains distorted MHC protein metabolism in skeletal muscle of humans with obesity.

The investigators evaluate protein metabolism in skeletal muscle of humans with obesity and lean controls, and focus specifically on that of MHC isoforms. The investigators determine gene expression of the MHC isoforms and associated molecular factors implicated in activating Type I muscle fiber programming. Acute aerobic exercise and increase in plasma amino acids are employed as experimental tools to target biological processes of transcription and translation related to MHC genes expression in skeletal muscle. The overall findings will provide an understanding of mechanisms responsible for unfavorable MHC proteome and fiber type phenotype in skeletal muscle of humans with obesity.

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 56 participants
• Allocation: Randomized
• Intervention Model: Crossover Assignment
• Masking: None (Open Label)
• Primary Purpose: Basic Science
• Official Title: Regulation of Muscle Protein Phenotype in Humans With Obesity
• Actual Study Start Date: October 7, 2021
• Estimated Primary Completion Date: June 2024
• Estimated Study Completion Date: June 2024

Arms and Interventions

Arm	Intervention/treatment
Experimental: Exercise, Infusion of Amino Acids; Exercise followed by infusion of amino acids, or infusion of amino acids alone.	Other: Exercise; Acute cycle-ergometer exercise for 45 minutes at 65% of peak oxygen uptake; Other: Infusion of Amino Acids; Intravenous infusion of mixture of amino acids
Active Comparator: Exercise; Exercise with no infusion of amino acids	Other: Exercise; Acute cycle-ergometer exercise for 45 minutes at 65% of peak oxygen uptake

Outcome Measures

Primary Outcome Measures :

1. Change in Protein Synthesis [ Time Frame: 9 Hours on 2 separate days one month apart ]

   Change from baseline in the synthesis rates of overall protein, overall mitochondrial protein, and myosin heavy chain (MHC) isoforms (MHC-I, MHC-IIa, and MHC-IIx) in skeletal muscle will be evaluated in response to the following interventions:

   1. exercise+amino acid infusion
   2. amino acid infusion
   3. exercise
2. Change in Eukaryotic initiation factor 4F (eIF4F) [ Time Frame: 9 Hours on 2 separate days one month apart ]

   Change from baseline in the formation of the active eIF4F complex in skeletal muscle will be evaluated in response to the following interventions:

   1. exercise+amino acid infusion
   2. amino acid infusion
   3. exercise
3. Change in mRNA [ Time Frame: 9 Hours on 2 separate days one month apart ]

   Change from baseline in mRNA content of MHC-I, MHC-IIa, and MHC-IIx in skeletal muscle will be evaluated in response to the following interventions:

   1. exercise+amino acid infusion
   2. amino acid infusion
   3. exercise

Secondary Outcome Measures :

1. Change in Protein breakdown [ Time Frame: 9 Hours on 2 separate days one month apart ]

   Change from baseline in the breakdown rates of overall protein and myosin heavy chain (MHC) isoforms (MHC-I, MHC-IIa, and MHC-IIx) in skeletal muscle will be evaluated in response to the following interventions:

   1. exercise+amino acid infusion
   2. amino acid infusion
   3. exercise

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 40 Years (Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes

Criteria

Inclusion Criteria:

• ability to sign informed consent form
• body mass index (BMI), 18-25 kg/m2 (lean subjects), 35-45 kg/m2 (subjects with obesity)
• insulin sensitivity (Matsuda insulin sensitivity index: lean > 7, subjects with obesity < 4).

Exclusion Criteria:

• prescription or over-the-counter medication
• supplements known to affect protein metabolism (i.e., amino acids, protein, omega-3 fatty acids)
• diabetes
• acute illness
• liver disease
• uncontrolled metabolic disease, including renal disease
• heart disease related to atrial fibrillation, history of syncope, limiting or unstable angina, congestive heart failure or ECG documented abnormalities such as >0.2 mV horizontal or downsloping ST-segment depression, or frequent arrhythmias (>10 premature ventricular contractions/min)
• low hemoglobin or hematocrit
• use of anabolic steroids or corticosteroids (within 3 months)
• not classified as inactive/sedentary based on the Stanford Brief Activity Survey and accelerometry data
• participation in a weight-loss regimen
• extreme dietary practices (i.e., vegan, vegetarian)
• smoking
• pregnancy
• gastro-intestinal surgery
• any other condition or event considered exclusionary by the PI and the study physician.

Contacts and Locations

Contacts

Contact: Christos S Katsanos; 480-301-6015; christos.katsanos@asu.edu

Contact: Lori R Roust; roust.lori@mayo.edu

Locations

United States, Arizona

Mayo Clinic in Arizona; Recruiting

Scottsdale, Arizona, United States, 85259

Sponsors and Collaborators

Mayo Clinic

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Investigators

• Principal Investigator: Lori R Roust, MD; Mayo Clinic
• Principal Investigator: Christos S Katsanos, PhD; Arizona State University

More Information

Additional Information:

Mayo Clinic Clinical Trials 

• Responsible Party: Lori R. Roust, Principal Investigator, Mayo Clinic
• ClinicalTrials.gov Identifier: NCT04700800
• Other Study ID Numbers: 20-003294; R01DK123441 ( U.S. NIH Grant/Contract )
• First Posted: January 8, 2021
• Last Update Posted: January 28, 2022
• Last Verified: January 2022

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:

Obesity; Overnutrition; Nutrition Disorders; Overweight; Body Weight