The Production of Reactive Oxygen Species in Response to Glutathione Supplementation and Acute Exercise

NCT02948673 | Completed

• 1 other identifier: DIMITOS
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

Objectives: The research focus of the study is the production of reactive oxygen species (ROS) in patients with type 2 diabetes (T2D) in response to glutathione (GSH) supplementation and in response to acute exercise. Oxidative stress is suggested as a possible causative factor in the pathophysiology of skeletal muscle insulin resistance. GSH is the most abundant endogenous antioxidant in the cell and thus, a crucial protector against oxidative stress and insulin resistance. It has been found that patients with T2D have a decreased level of GSH in plasma and that 1 h GSH infusion improves skeletal muscle glucose uptake by \~25% and the redox environment in patients with T2D. Therefore, we want to investigate the effect of 3 months of GSH supplementation on skeletal muscle insulin sensitivity and mitochondrial ROS production in patients with T2D and healthy controls. Hypothesis: Oral GSH supplementation will improve skeletal muscle insulin sensitivity in patients with T2D and this effect will be linked to a reduced mitochondrial ROS production in the skeletal muscle. In contrast to the link between oxidative stress and insulin resistance, ROS produced in response to exercise is an important physiological stimulus as it is suggested to play a key role in the beneficial mitochondrial biogenesis observed in response to training. It has been reported that some patients with T2D have a diminished mitochondrial biogenesis in response to training, but the reason for this defect is not known. We want to investigate the link between exercise-stimulated ROS production and the mitochondrial biogenesis response in patients with T2D and healthy controls in response to acute exercise at two different intensities. Hypothesis: Considering the pathological condition of T2D skeletal muscle (i.e. high chronic ROS level), we speculate that a lower exercise intensity, leading to a lower exercise-stimulated ROS production is a more optimal stimulus (i.e. not to high) for mitochondrial biogenesis in patients with T2D.

Conditions

Type 2 Diabetes; Oxidative Stress; Mitochondrial Reactive Oxygen Species Production

Keywords

type 2 diabetes; mitochondrial reactive oxygen species production; oxidative stress; antioxidant treatment; glutathione supplementation

Outcome Measures

Primary Outcomes (1)

• Insulin sensitivity

  Difference in insulin sensitivity (measured as glucose infusion rate during a hyperinsulinaemic euglycaemic clamp) between patients with type 2 diabetes receiving glutathione supplementation and patients with type 2 diabetes receiving placebo.

  12 weeks

Secondary Outcomes (1)

• Mitochondrial reactive oxygen species production

  12 weeks

Study Arms (2)

Control

PLACEBO COMPARATOR

4 placebo tablets/day (2 in the morning and 2 in the evening)

Other: Placebo

Glutathione

ACTIVE COMPARATOR

4 oral GSH tablets/day (2 in the morning and 2 in the evening)

Dietary Supplement: Glutathione

Interventions

Glutathione DIETARY_SUPPLEMENT

4 oral GSH tablets/day (1000mg/day) for 4 weeks

Also known as: Setria Glutathion

Glutathione

Placebo OTHER

4 oral placebo tablets for 4 weeks

Control

Eligibility Criteria

• Age: 30 Years - 50 Years
• Sex: male
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• For patients with type 2 diabetes:
• Male
• years
• BMI: 28-35
• ECG with no evidence of heart disease
• HbA1c \> 6.5% (48mmol/mol)
• For control subjects:
• Male
• years
• BMI: 28-35
• ECG with no evidence of Heart disease

You may not qualify if:

• For patients with type 2 diabetes::
• Insulin treatment
• Antioxidant supplementation or other dietary supplements
• Cholesterol lowering medicine
• For control subjects:
• Antioxidant supplementation or other dietary supplements
• Cholesterol lowering medicine

Sponsors & Collaborators

• University of Copenhagen: lead

Study Sites (1)

Xlab, Department of Biomedical Sciences, Faculty Of Health Sciences, University of Copenhagen

Copenhagen, Nørrebro, 2200, Denmark

Location

Related Publications (20)

• DeFronzo RA. Lilly lecture 1987. The triumvirate: beta-cell, muscle, liver. A collusion responsible for NIDDM. Diabetes. 1988 Jun;37(6):667-87. doi: 10.2337/diab.37.6.667. No abstract available.

  PMID: 3289989 BACKGROUND

• Houstis N, Rosen ED, Lander ES. Reactive oxygen species have a causal role in multiple forms of insulin resistance. Nature. 2006 Apr 13;440(7086):944-8. doi: 10.1038/nature04634.

  PMID: 16612386 BACKGROUND

• Anderson EJ, Lustig ME, Boyle KE, Woodlief TL, Kane DA, Lin CT, Price JW 3rd, Kang L, Rabinovitch PS, Szeto HH, Houmard JA, Cortright RN, Wasserman DH, Neufer PD. Mitochondrial H2O2 emission and cellular redox state link excess fat intake to insulin resistance in both rodents and humans. J Clin Invest. 2009 Mar;119(3):573-81. doi: 10.1172/JCI37048. Epub 2009 Feb 2.

  PMID: 19188683 BACKGROUND

• Abdul-Ghani MA, Jani R, Chavez A, Molina-Carrion M, Tripathy D, Defronzo RA. Mitochondrial reactive oxygen species generation in obese non-diabetic and type 2 diabetic participants. Diabetologia. 2009 Apr;52(4):574-82. doi: 10.1007/s00125-009-1264-4. Epub 2009 Jan 30.

  PMID: 19183935 BACKGROUND

• Hey-Mogensen M, Hojlund K, Vind BF, Wang L, Dela F, Beck-Nielsen H, Fernstrom M, Sahlin K. Effect of physical training on mitochondrial respiration and reactive oxygen species release in skeletal muscle in patients with obesity and type 2 diabetes. Diabetologia. 2010 Sep;53(9):1976-85. doi: 10.1007/s00125-010-1813-x. Epub 2010 Jun 6.

  PMID: 20526759 BACKGROUND

• Chanseaume E, Barquissau V, Salles J, Aucouturier J, Patrac V, Giraudet C, Gryson C, Duche P, Boirie Y, Chardigny JM, Morio B. Muscle mitochondrial oxidative phosphorylation activity, but not content, is altered with abdominal obesity in sedentary men: synergism with changes in insulin sensitivity. J Clin Endocrinol Metab. 2010 Jun;95(6):2948-56. doi: 10.1210/jc.2009-1938. Epub 2010 Apr 9.

  PMID: 20382691 BACKGROUND

• Murphy MP. How mitochondria produce reactive oxygen species. Biochem J. 2009 Jan 1;417(1):1-13. doi: 10.1042/BJ20081386.

  PMID: 19061483 BACKGROUND

• Richie JP Jr, Nichenametla S, Neidig W, Calcagnotto A, Haley JS, Schell TD, Muscat JE. Randomized controlled trial of oral glutathione supplementation on body stores of glutathione. Eur J Nutr. 2015 Mar;54(2):251-63. doi: 10.1007/s00394-014-0706-z. Epub 2014 May 5.

  PMID: 24791752 BACKGROUND

• Calabrese V, Cornelius C, Leso V, Trovato-Salinaro A, Ventimiglia B, Cavallaro M, Scuto M, Rizza S, Zanoli L, Neri S, Castellino P. Oxidative stress, glutathione status, sirtuin and cellular stress response in type 2 diabetes. Biochim Biophys Acta. 2012 May;1822(5):729-36. doi: 10.1016/j.bbadis.2011.12.003. Epub 2011 Dec 11.

  PMID: 22186191 BACKGROUND

• De Mattia G, Bravi MC, Laurenti O, Cassone-Faldetta M, Armiento A, Ferri C, Balsano F. Influence of reduced glutathione infusion on glucose metabolism in patients with non-insulin-dependent diabetes mellitus. Metabolism. 1998 Aug;47(8):993-7. doi: 10.1016/s0026-0495(98)90357-2.

  PMID: 9711998 BACKGROUND

• Pilegaard H, Saltin B, Neufer PD. Exercise induces transient transcriptional activation of the PGC-1alpha gene in human skeletal muscle. J Physiol. 2003 Feb 1;546(Pt 3):851-8. doi: 10.1113/jphysiol.2002.034850.

  PMID: 12563009 BACKGROUND

• Hood DA. Invited Review: contractile activity-induced mitochondrial biogenesis in skeletal muscle. J Appl Physiol (1985). 2001 Mar;90(3):1137-57. doi: 10.1152/jappl.2001.90.3.1137.

  PMID: 11181630 BACKGROUND

• Silveira LR, Pilegaard H, Kusuhara K, Curi R, Hellsten Y. The contraction induced increase in gene expression of peroxisome proliferator-activated receptor (PPAR)-gamma coactivator 1alpha (PGC-1alpha), mitochondrial uncoupling protein 3 (UCP3) and hexokinase II (HKII) in primary rat skeletal muscle cells is dependent on reactive oxygen species. Biochim Biophys Acta. 2006 Sep;1763(9):969-76. doi: 10.1016/j.bbamcr.2006.06.010. Epub 2006 Jul 7.

  PMID: 16916551 BACKGROUND

• Kang C, O'Moore KM, Dickman JR, Ji LL. Exercise activation of muscle peroxisome proliferator-activated receptor-gamma coactivator-1alpha signaling is redox sensitive. Free Radic Biol Med. 2009 Nov 15;47(10):1394-400. doi: 10.1016/j.freeradbiomed.2009.08.007. Epub 2009 Aug 14.

  PMID: 19686839 BACKGROUND

• Irrcher I, Ljubicic V, Hood DA. Interactions between ROS and AMP kinase activity in the regulation of PGC-1alpha transcription in skeletal muscle cells. Am J Physiol Cell Physiol. 2009 Jan;296(1):C116-23. doi: 10.1152/ajpcell.00267.2007. Epub 2008 Nov 12.

  PMID: 19005163 BACKGROUND

• Sriwijitkamol A, Coletta DK, Wajcberg E, Balbontin GB, Reyna SM, Barrientes J, Eagan PA, Jenkinson CP, Cersosimo E, DeFronzo RA, Sakamoto K, Musi N. Effect of acute exercise on AMPK signaling in skeletal muscle of subjects with type 2 diabetes: a time-course and dose-response study. Diabetes. 2007 Mar;56(3):836-48. doi: 10.2337/db06-1119.

  PMID: 17327455 BACKGROUND

• De Filippis E, Alvarez G, Berria R, Cusi K, Everman S, Meyer C, Mandarino LJ. Insulin-resistant muscle is exercise resistant: evidence for reduced response of nuclear-encoded mitochondrial genes to exercise. Am J Physiol Endocrinol Metab. 2008 Mar;294(3):E607-14. doi: 10.1152/ajpendo.00729.2007. Epub 2008 Jan 8.

  PMID: 18182465 BACKGROUND

• Holten MK, Zacho M, Gaster M, Juel C, Wojtaszewski JF, Dela F. Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes. Diabetes. 2004 Feb;53(2):294-305. doi: 10.2337/diabetes.53.2.294.

  PMID: 14747278 BACKGROUND

• Phielix E, Meex R, Moonen-Kornips E, Hesselink MK, Schrauwen P. Exercise training increases mitochondrial content and ex vivo mitochondrial function similarly in patients with type 2 diabetes and in control individuals. Diabetologia. 2010 Aug;53(8):1714-21. doi: 10.1007/s00125-010-1764-2. Epub 2010 Apr 27.

  PMID: 20422397 BACKGROUND

• Sondergard SD, Cintin I, Kuhlman AB, Morville TH, Bergmann ML, Kjaer LK, Poulsen HE, Giustarini D, Rossi R, Dela F, Helge JW, Larsen S. The effects of 3 weeks of oral glutathione supplementation on whole body insulin sensitivity in obese males with and without type 2 diabetes: a randomized trial. Appl Physiol Nutr Metab. 2021 Sep;46(9):1133-1142. doi: 10.1139/apnm-2020-1099. Epub 2021 Mar 19.

  PMID: 33740389 DERIVED

MeSH Terms

Conditions

Diabetes Mellitus, Type 2

Interventions

Glutathione

Condition Hierarchy (Ancestors)

Diabetes Mellitus; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases

Intervention Hierarchy (Ancestors)

Oligopeptides; Peptides; Amino Acids, Peptides, and Proteins

Study Officials

• Steen Larsen, Ass. prof.

  University of Copenhagen

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: BASIC SCIENCE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor, DMSci.

Study Record Dates

• First Submitted: October 26, 2016
• First Posted: October 28, 2016
• Study Start: May 1, 2016
• Primary Completion: December 1, 2017
• Study Completion: December 1, 2017
• Last Updated: May 2, 2018

Record last verified: 2018-05

Data Sharing

• IPD Sharing: Will not share

Locations

DK (1)