NCT00962806

Brief Summary

Obesity and type 2 diabetes are occurring at epidemic rates in the United States and worldwide. The global burden of diabetes is estimated to double over the next 25 years. Obese children are at risk for the development of insulin resistance, relative insulin deficiency and type 2 diabetes mellitus (DM). The prevention of type 2 DM is hindered by the lack of a non-invasive predictive test, knowledge as to individual risk and effective preventative measures. There is increasing evidence that alterations in mitochondria contribute to the development of diabetes in humans. Therefore, it is important to explore mitochondrial dysfunction as a potential predictor of diabetes in children and a potential target for prevention. The aims of the proposed protocol are to determine whether an intensive exercise intervention can improve mitochondrial function in children identified as having mitochondrial dysfunction and insulin resistance. The use of a non-invasive imaging technique will allow for a functional in vivo assessment of mitochondrial activity. The investigators propose the investigation of an intensive exercise protocol designed to improve mitochondrial function in children who are insulin resistant and have documented mitochondrial dysfunction by magnetic resonance spectroscopy. The study is designed to investigate the plasticity of abnormal mitochondrial function in high risk children. In summary, the proposed projects will investigate mitochondrial function as a non-invasive predictive marker for the development of insulin resistance and type 2 diabetes mellitus in children and attempt to modify mitochondrial function with an intensive exercise intervention. The study of mitochondrial dysfunction in children may both identify those at risk for disease and provide a molecular therapeutic target for prevention and treatment. The investigators hypothesize that children with insulin resistance and mitochondrial dysfunction who are randomized to intensive exercise versus standard lifestyle advice will show improvement in mitochondrial function and insulin sensitivity.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
40

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Aug 2009

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

August 1, 2009

Completed
17 days until next milestone

First Submitted

Initial submission to the registry

August 18, 2009

Completed
2 days until next milestone

First Posted

Study publicly available on registry

August 20, 2009

Completed
2.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2012

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2012

Completed
Last Updated

April 27, 2012

Status Verified

April 1, 2012

Enrollment Period

2.8 years

First QC Date

August 18, 2009

Last Update Submit

April 25, 2012

Conditions

Keywords

Pediatric obesityInsulin resistanceDiabetesMitochondria

Outcome Measures

Primary Outcomes (1)

  • Determine whether intensive exercise improves mitochondrial function by P31 MRS and mitochondrial number by peripheral blood analyses.

    2 year

Secondary Outcomes (2)

  • Determine whether intensive exercise improves metabolic parameters and glucose metabolism.

    2 years

  • Determine whether intensive exercise improves body composition, by DXA, and intramyocellular fat content, by 1H MRS.

    2 years

Study Arms (2)

Exercise

ACTIVE COMPARATOR

8 week intensive exercise group

Behavioral: Exercise

Control Lifestyle counseling

OTHER

Lifestyle counseling without intensive exercise

Behavioral: Lifestyle counseling

Interventions

ExerciseBEHAVIORAL

8 weeks of intensive exercise, 60-90 minutes 3 days each week

Exercise

Baseline and final visit dietary and activity advice and weekly healthy lifestyle messages

Control Lifestyle counseling

Eligibility Criteria

Age10 Years - 18 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • Girls and boys ages 10 to 18 years old
  • Body mass index more than 95th percentile for age and gender
  • Insulin resistance based on:
  • Fasting parameters: Fasting insulin level, HOMA IR
  • Oral glucose tolerance testing
  • Mitochondrial function \> 1 median for normal based on control cohort

You may not qualify if:

  • Underlying medical problem with potential to affect growth, pubertal development or glucose homeostasis
  • Chronic medical therapy with glucocorticoids, growth hormone, estrogen, progesterone, testosterone, or other medications with the potential to alter growth, pubertal development or glucose homeostasis within the proceeding 6 months
  • Personal history of DM
  • Inability to have MRI scan performed due to metal prosthesis or implant

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

Location

MeSH Terms

Conditions

Pediatric ObesityInsulin ResistanceMitochondrial DiseasesDiabetes Mellitus

Interventions

Exercise

Condition Hierarchy (Ancestors)

ObesityOverweightOvernutritionNutrition DisordersNutritional and Metabolic DiseasesBody WeightSigns and SymptomsPathological Conditions, Signs and SymptomsHyperinsulinismGlucose Metabolism DisordersMetabolic DiseasesEndocrine System Diseases

Intervention Hierarchy (Ancestors)

Motor ActivityMovementMusculoskeletal Physiological PhenomenaMusculoskeletal and Neural Physiological Phenomena

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Professor

Study Record Dates

First Submitted

August 18, 2009

First Posted

August 20, 2009

Study Start

August 1, 2009

Primary Completion

June 1, 2012

Study Completion

December 1, 2012

Last Updated

April 27, 2012

Record last verified: 2012-04

Locations