The body shape of obese women varies between having the majority of fat either above the waist ("apple" shape) or below the waist ("pear" shape). The study will investigate what restricts: apple"-shaped women from being "pear"-shaped at the cellular level. Since "pear" shaped women tend to have better health, this study will open the door to future research in regulating body shape and thus improving health.
Adipose tissue expandability and the distribution of stored fat in the body are stronger predictors of health risk. A better understanding of the factors that determine regional fat mass growth may lead to developing new strategies for prevention or treatment of metabolic complications of obesity. The objective of this proposal is to study the responsiveness of different fat depots to adipogenic stimulation in upper-body and lower-body obese women.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
SINGLE
Enrollment
63
30mg per day for four months
Pennington Biomedical Research Center
Baton Rouge, Louisiana, United States
Pennington Biomedical Research Center
Baton Rouge, Louisiana, United States
In Vivo Adipose Cell Formation (Adipogenesis)
Following the consumption of water labeled with the stable isotope deuterium (2H2O; heavy water), adipose tissue biopsies from the subcutaneous abdominal and femoral (thigh) depots will be collected. The 2H from the heavy water is enriched into the DNA of newly synthesized cells. Measures of DNA synthesis (obtained via gas chromatography and mass spectrometry analysis of 2H-enrichment) denote new adipose cell formation, or adipogenesis. The primary outcome is to assess the change (from baseline) in adipose cell formation rates (i.e. adipogenesis) in response to 16-weeks of pioglitazone versus the control group.
Time frame: Change from baseline in adipogenesis at 16 weeks
Visceral Adipose Tissue (Percentage of Total Abdominal Adipose Tissue)
The volume of fat tissue around the internal organs in the abdomen (visceral adipose tissue; VAT) and underneath the skin (subcutaneous abdominal adipose tissue; scABD) will be determined by Magnetic Resonance Imaging (MRI) of the abdominal region. VAT:total abdominal AT (TAT) reflects the percentage of abdominal fat that is VAT and is calculated as VAT/(scABD AT + VAT).
Time frame: Change from baseline in visceral fat at 16 weeks
Lipid Accretion in the Liver (Intra-hepatic Lipid; IHL)
Lipid accretion in the liver cells will be measured using 1H-MRS of the liver.
Time frame: Change from Baseline in intra-hepato-cellular lipid at 16 weeks
Matsuda Index (Measure of Insulin Sensitivity)
Insulin sensitivity (glucose tolerance) will be assessed using an oral 75 g oral glucose tolerance test (OGTT) after an overnight fast. Blood samples will be collected at 0, 30, 60, 90, and 120 min after glucose administration to measure serum glucose and insulin. Insulin sensitivity was calculated using the Matsuda insulin sensitivity index \[10,000/ √(glucose 0' x insulin 0') X (mean glucose OGTT x mean insulin OGTT)\]. A higher value denotes increased insulin sensitivity.
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Time frame: Change from Baseline in Matsuda Index at 16 weeks