NAFLD - Nonalcoholic Fatty Liver Disease
Conditions
Brief summary
Non-alcoholic fatty liver disease (NAFLD) covers a spectrum from reversible hepatic steatosis to inflammation and fibrosis termed steatohepatitis (NASH) and cirrhosis. New evidence indicates that NAFLD is associated with development of heart failure, abnormal ventricular glucose and fatty acid (FA) utilisation and cardiosteatosis. The mechanisms behind cardiac involvement and the progression from NAFLD to NASH are poorly understood but must include altered cardiac and intrahepatic lipid handling. In collaboration with renowned research groups from Oxford, Mayo Clinic and Copenhagen investigators plan comprehensive kinetic studies of heart and liver FA uptake and oxidation, ventricular function and substrate utilisation, and hepatic triglyceride (TG) secretion in order to assess mechanisms governing cardiac and hepatic lipid and glucose trafficking in subjects with NAFLD and NASH and the relationship with heart function. In addition, the investigators will assess skeletal muscle and adipose tissue enzyme activities, gene expression and protein concentrations in these subjects to define mechanisms involved in the cross-talk between heart, liver, muscle and adipose tissues. Investigators will address these questions using innovative tracer techniques (11Cpalmitate, 11C acetate, 18FDG glucose PET tracers and TG tracers) in combination with hepatic vein catherisation to study cardiac and liver substrate trafficking, as well as NMR spectroscopy, echocardiography, muscle and fat biopsies in combination with state-of-the art muscle and adipose tissue enzyme kinetics, gene- and protein expression. Effects of acute exercise will be assessed. The overarching goals are to define abnormalities and differences between NAFLD and NASH in hepatic lipid (FA and TG) metabolism and to assess the effect of exercise on both hepatic, cardiac and adipose and skeletal muscle lipid and substrate utilisation.
Interventions
BEHAVIORALExercise
Moderate Intensity Exercise (50 % af VO2max) for 90 minutes
Sponsors
University of Aarhus
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
Experimental: 1 Healthy male volunteers Behavioral: Exercise Moderate Intensity Exercise (50 % af VO2max) for 90 minutes before and after PET scanning, Experimental: 2 Healthy female volunteers Moderate Intensity Exercise (50 % af VO2max) for 90 minutes before and after a PET scanning.
Eligibility
Sex/Gender
ALL
Age
40 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
* 10 obese subject men/women with NAFLD (MR spectroskopi, fibro scanner) (BMI \> 30). * 10 obese subject men/women without NAFLD (MR spectroskopi, fibro scanner) (BMI \> 30). * age between 40-70 years * Written consent before the start of the study
Exclusion criteria
* known current disease * Fixed Medical drug consumption, statins and antihypertensive drugs (non-beta blocker). However, pause 3 weeks before the examination date * Blood donation within the last 3 months prior to the study * Participation in experiments involving radioactive isotopes within the last 6 months * Alcohol abuse (over 21 items per week for men and 14 for women) * Smoking * Weight over 130 kg * Cancer patients * Large intake of medication
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The effect of physical activity on the heart's metabolism of fatty acids in obese with and without NAFLD | 2 years | Primary outcome: \- Fatty acid uptake (mg/kg/min) in the Heart in obese with and without NAFLD |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| To determine the effect of an acute exercise bout on the improvement of cardiac FA utilization in obese with and without NAFLD. | 2 years | Fatty acid oxidation (µmol/min) in the Heart in obese with and without NAFLD. |
Countries
Denmark
Outcome results
None listed