A Study of Niacin Regulation

Launched by MAYO CLINIC · Dec 7, 2023

Keywords

ClinConnect Summary

This clinical trial is studying how fat cells in people who gain weight mainly in their stomach area react differently compared to those who are lean. Researchers want to understand why some adults, particularly those who are overweight or obese, may not respond well to treatments that help reduce fat. The trial is currently looking for participants aged 18 to 65 who have a body mass index (BMI) between 29.0 and 40.0 kg/m², which means they are considered overweight or obese. Eligible individuals should also have specific measurements of body fat, particularly around the waist, and meet other health criteria.

Participants in this study will follow a controlled diet for a few days and may undergo some tests to monitor their health. It's important for potential participants to know that the study has certain exclusions, such as those with a history of heart disease or certain medical conditions, as well as those who smoke. Overall, this trial aims to better understand how body types can affect weight management and treatment responses, which could lead to more effective strategies for managing weight gain in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Males and females between 18 and 65 years of age who are able to comprehend instructions, follow study procedures, willing to sign an informed consent form, and consume an isoenergetic diet eating all meals from Mayo CRTU for at least 3 days prior to study.
• • Overweight/Obese volunteers will have a BMI 29.0 - 40.0 kg/m2.
• • Upper body/visceral obesity (UBO) in women will be defined as those with a waist-hip ratio (WHR) \> 0.85 and/or increased visceral fat by single slice CT scan, usually with \> 120 cm2 of visceral fat by CT scanning or a visceral fat/total fat ratio of \> 0.30, and/or biochemical evidence of metabolic syndrome as defined by ATP III criteria (fasting plasma triglycerides ≥ 150 mg/dL, HDL-cholesterol \< 50 mg/dL for women and \< 40 mg/dL for men, fasting plasma glucose ≥ 100 mg/dL). Upper body obesity in men will be defined as a waist-hip ratio of \> 0.95 and/or increased visceral fat (visceral fat area \> 180 cm2 or a visceral/total fat abdominal ratio by CT of \> 0.40) by single slice CT scan and/or biochemical evidence of metabolic syndrome as defined by ATP III criterial. These visceral fat values are based upon the data collected at Mayo Clinic using our methods, and are correlated with dyslipidemia and hyperinsulinemia.
• • Female subjects are eligible if they meet the following criteria: are not pregnant or nursing; all women of childbearing potential will have a negative urine pregnancy test at screening and a negative urine pregnancy test within 48 hours before administering study drug; all women of childbearing potential will use an appropriate contraceptive method, including barrier method, oral contraceptive medication, contraceptive device or abstinence while participating in the study. They will confirm use of one of these methods.
• • Recent or current research participation in a study that involves an investigational drug. Participants in other clinical trials that involve an investigational drug will not be able to participate in this study until 12 weeks after their participation in the other study is complete or \> than five half-lives of the compound, whichever is longer: if Yes look at consent form and f/u visits: current use of medications that alter fatty acid or adipose metabolism possibly given: if yes, exclude;
• • Amount of blood drawn during the study (if our study plus this one draw ≥ 450 ml these should be separated by 8 weeks.
• • Previous labs: HbA1C \< 6.5% for non-diabetic UBO; Fasting glucose \< 126 mg/dl for non-diabetic UBO; Hb ≥ 11.0 for women and ≥ 12 for men; platelets \> 100 000.
• Exclusion Criteria:
• • Individuals with a history of a disease process such as: ischemic heart disease; atherosclerotic valvular disease; persistent blood pressure greater than 160/95 despite antihypertensive medication.
• • Smokers.
• • Concomitant use of medications that can alter free fatty acid metabolism: high dose fish oil (\>3g per day), (if yes, discontinue for 6 weeks); statins (if yes hold for 4 weeks and receive primary care provider's approval); Niacin; Fibrates; thiazolidinediones; Beta-blockers; Oral or injected corticosteroids or anabolic steroids; any history of use of pioglitazone; atypical antipsychotics.
• • Allergy to lidocaine.
• • Allergy to Niaspan documented by immunological testing.
• • Allergy to indocyanine green.