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Effects of Fish Oils on Inflammation and Insulin Resistance


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  • Purpose

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    The purpose of this study is to determine whether improvement in fat and muscle metabolism after the treatment with Omacor (fish oils) provides insight into the link between obesity, fat and muscle function leading to metabolic syndrome, which is a risk factor for heart disease and diabetes.


    status: active, not recruiting
    conditions: Metabolic Syndrome ; Insulin Resistance
    interventions: omega-3 fatty acid ; placebo
    phase: N/A
    study type: Interventional
    study design: Basic Science, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Parallel Assignment, Efficacy Study
    official title: Effects of Fish Oils on Inflammation and Insulin Resistance

  • Further study details (as provided by University of Arkansas)

    primary outcome measures:

    secondary outcome measures:

    • Fish oils improve peripheral insulin sensitivity through a reduction of intramyocellular lipid. [ Time Frame: December 2009 ]

    enrollment: 135

    study start date: January 2007

    study completion date: December 2009


    Arms Assigned Interventions

    1: Active Comparator

    4g Omacor (omega-3 fatty acid) daily.

    Drug: omega-3 fatty acid

    4g of omega-3 fatty acid daily by mouth for 12 weeks.

    2: Placebo Comparator

    placebo (4 non-active capsules daily)

    Drug: placebo

    4 inert capsules daily by mouth for 12 weeks.

    Detailed description

    The development of type 2 diabetes (T2DM) represents a complex series of events, involving abnormalities in adipose tissue lipid distribution and insulin action. Along with an increase in adipose tissue mass is an increase in inflammation brought about by macrophages that infiltrate adipose tissue. These macrophages express inflammatory cytokines such as TNF- and IL-6, which are correlated with insulin resistance and metabolic syndrome, and suggest that metabolic syndrome and diabetes are conditions characterized by a state of chronic, low-grade inflammation. Thiazolidinediones (TZDs) improve insulin sensitivity via activation of PPAR- , and there is much evidence that PPAR agonists also have anti-inflammatory properties.
    Fish oils are rich sources of Omega-3 fatty acids and there is a large literature on the potential benefits of fish oils on lowering serum triglycerides, cardiovascular protection, and immune modulation, and there is evidence that fish oils also activate PPAR . Hence, the focus of this study will be on subjects with insulin resistance and metabolic syndrome, but who do not yet have diabetes. We plan to treat insulin resistant subjects with fish oils and ask the following questions.
    Hypothesis 1. The treatment of insulin resistant subjects with fish oils will reduce adipose tissue inflammation. Aim 1. From blood samples drawn before and after treatment, we will measure levels of circulating inflammatory cytokines. Aim 2. Adipose tissue biopsies will be performed before and after fish oil treatment. From the adipose biopsies, we will quantitate cytokine expression, macrophage number, and we will look for evidence of macrophage apoptosis. Aim 3. We will determine whether fish oil treatment increases the adipose tissue secretion and serum level of the high molecular weight form of adiponectin.
    Hypothesis 2. The reduction in inflammatory markers occurs through an activation of PPAR by the fish oils.
    Aim 4. Adipose tissue and macrophages will be treated in vitro with fish oils in the presence and absence of a PPAR inhibitor. We will determine whether fish oils stimulate the secretion of the high molecular weight adiponectin isoform from adipose tissue and whether they induce apoptosis from macrophages, and whether this process is inhibited by the PPAR inhibitor. Hypothesis 3. Fish oils improve peripheral insulin sensitivity through a reduction in intramyocellular lipid, and an improvement in muscle insulin signal transduction. Aim 5. Before and after treatment with fish oils, insulin sensitivity will be measured, along with intramyocellular lipid and genes involved in insulin action and muscle lipid oxidation.

  • Eligibility

    ages eligible for study: 35 Years to 65 Years
    genders eligible for study: Both

    Criteria

    Inclusion Criteria:
    • BMI 27-45 kg/m2
    • age 35-65 years
    • abnormal carbohydrate metabolism

    Exclusion Criteria:

  • Contacts and locations

    Please refer to this study by its ClinicalTrials.gov identifier: NCT00579436

    Locations

    United States , Arkansas  - University of Arkansas for Medical Sciences

    facility: Little Rock, Arkansas, United States, 72205

  • Sponsors and collaborators

    University of Arkansas
    Reliant Pharmaceuticals

    investigators: Philip A. Kern, M.D., Principal Investigator, University of Arkansas

  • More information

    first received: December 20, 2007
    last updated: May 4, 2009
    ClinicalTrials.gov Identifier: NCT00579436
    health authority: United States: Institutional Review Board
    United States: Food and Drug Administration

Information obtained from ClinicalTrials.gov on September 25, 2009   Link to the current ClinicalTrials.gov record.

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