Effect of Moderate Weight Loss in Metabolically Abnormal Lean Subjects

NCT ID: NCT02452567

Last Updated: 2021-05-28

Basic Information

• Recruitment Status: WITHDRAWN
• Clinical Phase: NA
• Study Classification: INTERVENTIONAL
• Study Start Date: 2015-05-31
• Study Completion Date: 2021-05-31

Brief Summary

Obesity is associated with a constellation of cardiometabolic abnormalities (including insulin resistance, elevated blood pressure and dyslipidemia) that are risk factors for diabetes and cardiovascular disease. Weight loss can improve all of the cardiometabolic abnormalities associated with obesity. Up to ~25% of lean people (Body Mass Index [BMI] 18.5-24.9 kg/m²) have many of the cardiometabolic abnormalities associated with obesity and are referred to as metabolically abnormal lean (MAL) people. However, the MAL phenotype is not well characterized, and it is unclear whether weight loss has beneficial metabolic effects in already lean people. Accordingly, the goal of this study is to: 1) carefully phenotype MAL people and 2) evaluate the effect of moderate (8-10%) diet-induced weight loss in MAL people. This will be investigated in 15 MAL (defined as having 2 or more of the following: intrahepatic triglyceride (IHTG) content ≥5.6%, glycated hemoglobin ≥5.7%, fasting plasma glucose concentration ≥100 mg/dl, 2-hr oral glucose tolerance test (OGTT) plasma glucose concentration ≥140 mg/dl, homeostatic model assessment of insulin resistance (HOMA-IR) ≥ 2.5) men and women. Only lean people who have a BMI ≥21.0 but <25.0 kg/m² will be asked to lose weight to avoid the risk that participants become underweight (BMI <18.5 kg/m²) during weight loss therapy.

Conditions

Weight Loss

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: OTHER
• Blinding Strategy: NONE

Study Groups

Metabolically abnormal lean

Moderate (8-10%) diet-induced weight loss.

Group Type: EXPERIMENTAL

Moderate (8-10%) diet-induced weight loss

Intervention Type: OTHER

MAL participants will meet with the study dietitian to lose \~8-10% of their body weight through diet-intervention.

Interventions

Moderate (8-10%) diet-induced weight loss

MAL participants will meet with the study dietitian to lose \~8-10% of their body weight through diet-intervention.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• BMI 21.0-24.9 kg/m²
• Weight stable (+/- 2% for at least 3 months before enrollment)
• Two or more of the following: IHTG content ≥5.6%, HOMA- IR index ≥ 2.5, HbA1C ≥ 5.7%, 2-hr OGTT plasma glucose concentration ≥ 140 mg/dl, fasting plasma glucose concentration ≥ 100 mg/dl.

Exclusion Criteria

• Women who are pregnant or breastfeeding
• Evidence of significant organ system dysfunction or disease (e.g., diabetes, chronic kidney disease, advanced heart disease, etc.)
• Men who consume >21 units (e.g., glass of wine or bottle of beer) of alcohol per week and women who consume >14 units of alcohol per week
• Use of dietary supplements or medications known to affect metabolism
• Eating disorder (assessed by using the Eating Disorder Examination Questionnaire [EDE-Q])
• Participation in structured endurance or resistance exercise program >150 min/week
• Use of tobacco products
• Unable or unwilling to follow the study protocol or the research team believes that for any reason the volunteer is not an appropriate candidate for this study, including non-compliance with screening appointments or previous appointments/contact arrangements
• Individuals that take Coumadin or similar anticoagulants
• Use of antibiotics in last 60 days
• Previous bariatric surgery
• Cancer or cancer that has been in remission for <5 years
• Major psychiatric illness

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 55 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Washington University School of Medicine

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Samuel Klein, MD

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Locations

Washington University School of Medicine

St Louis, Missouri, United States

Countries

United States

Other Identifiers

201501010

Identifier Type: -

Identifier Source: org_study_id