Insulin Resistance, Obesity
Conditions
Keywords
Obesity, Insulin Resistance, functional magnetic resonance imaging, glucose, fructose, hypothalamus, neuronal circuits, feeding behavior
Brief summary
To explore whether obese adolescents with insulin resistance and relative low leptin levels exhibit functional alterations of the neuronal circuits involved in the regulation of energy metabolism and food seeking behaviors. We here propose to test the hypothesis that the reward circuitry is dysregulated in obese adolescents and is related to the degree of insulin resistance and hyperinsulinemia.
Detailed description
Functional Magnetic Resonance Imaging (fMRI) provides a non-invasive method to assess the functional pathways affected by nutrient ingestion and therefore can help answer important questions regarding potential differences in the response of brain regions involved in feeding.
Interventions
None listed
Sponsors
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Yale University
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
12 Years to 17 Years
Healthy volunteers
Yes
Inclusion criteria
* Obese adolescents * Good general health, * taking no medication on a chronic basis * Age 12 to 17 yrs, * in puberty (girls and boys: Tanner stage II - IV) Obese Insulin Resistant Adolescents * (BMI\> 95th) * (WBISI\<1.2 plus a low adiponectin \<6 ug/dl and * high triglyceride levels \>130mg/dl) Obese Insulin Sensitive Adolescents * (BMI\>95th) * (WBISI \>3) plus high adiponectin \>8 ug/ml and * triglyceride levels \> 80 mg/dl Girls who begin menstruating must have a negative pregnancy test during the study Eligibility criteria for healthy non-obese children and adolescents: * Brother or sister with obesity * Age 12 to 17 years * Normal fasting glucose and lipids in the child, and * normal OGTT * No use of any medication known to affect glucose, lipid metabolism and inflammation * No endocrinopathies * No use of any antipsychotic medication * BMI \>25th to \<75th ( Center for Disease Control (CDC) BMI Charts) * Minimum weight of 90lbs (CDC Growth Charts)
Exclusion criteria
* Baseline creatinine \>1.0 mg * Pregnancy * Presence of endocrinopathies (e.g. Cushing syndrome) * Cardiac or pulmonary or other significant chronic illness * Adolescents with psychiatric disorder or with substance abuse determined via self-report. * Use of anorexic agents No metal implants
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| measure of cerebral blood flow response to glucose ingestion | Baseline and 2 year follow up | fmri on 3T to measure blood flow response after ingestion of glucose drink |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| measure of cerebral blood flow response to fructose ingestion | Baseline and 2 year follow up | fmri on 3T to measure blood flow response after ingestion of fructose drink |
Other
| Measure | Time frame | Description |
|---|---|---|
| measure of BOLD signal brain reactivity to food cues | Baseline and 2 year follow up | fmri on 3T to measure blood flow response to visually presented food cues |
Countries
United States
Outcome results
None listed