Study to Investigate Adipocyte Cell and Lipid Turnover in Obese Adolescents

Study Overview
=================
Brief Summary
-----------------
Insulin Resistance is the best predictor of whether the obese adolescent will develop type 2 diabetes. The present studies will focus on determining what might cause fat to accumulate in the subcutaneous fat regions and lead to local inflammation, causing insulin resistance to develop in obese adolescents.

Detailed Description
-----------------
The purpose of this study is to test whether the reduced transcription of key lipogenic/adipogenic genes in abdominal subcutaneous adipose tissue (SAT) in obese adolescents with a High VAT/SAT (visceral adipose tissue/subcutaneous adipose tissue) ratio translates functionally into a reduced in vivo triglyceride (TG) synthesis and adipocyte proliferation, which in turn will contribute to ectopic fat accumulation and insulin resistance (IR). To test whether the storage capacity of gluteal SAT is linked to the level of VAT/SAT fat distribution in obese adolescents. To explore if changes in dietary fat intake (palmitate intake) alters ceramide concentration in both plasma and adipose tissue (AT) and the Inflammasome complex in the different fat distribution phenotypes and their associations with IR.

Official Title
-----------------
Study to Investigate Adipocyte Cell and Lipid Turnover in Obese Adolescents

Conditions
-----------------
Pediatric Obesity

Intervention / Treatment
-----------------
* Other: Palmitate Diet


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Overweight (85-95th% age and gender specific) or Obese (>95th% age and gender specific) Ages 12-18 years Absence of any endocrinopathy Absence of any therapy with medication known to alter glucose metabolism (i.e.: Oral steroids, certain psychiatric medications such as Xeleca, Lithium, Paxil) English Speaking subjects Exclusion Criteria: Any disease known to alter glucose metabolism (T2DM) Diuretic Medication Pregnant or breastfeeding Type 1 or 2 diabetes

Ages Eligible for Study
-----------------
Minimum Age: 12 Years
Maximum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| High VAT/SAT high Palmitate Diet<br>Subjects with a high ratio of visceral to subcutaneous fat consuming high Palmatite oil diet for 12 weeks | Other: Palmitate Diet<br>* Subject with high VAT/SAT ratio will be randomized to a high or low palmitate oil diet.<br>|
| Low VAT/SAT<br>Subjects with a low ratio of visceral to subcutaneous fat | Other: Palmitate Diet<br>* Subject with high VAT/SAT ratio will be randomized to a high or low palmitate oil diet.<br>|
| Lean Controls<br>Lean control | |
| High VAT/SAT- low Palmitate Diet<br>Subjects with a high ratio of visceral to subcutaneous fat consuming low Palmatite oil diet for 12 weeks | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fat Biopsies | 1) To test whether the reduced transcription of key lipogenic/adipogenic genes in abd SAT in obese adolescents with a High VAT/SAT ratio translates functionally into a reduced in vivo TG synthesis and adipocyte proliferation, which in turn will contribute to ectopic fat accumulation and IR. | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| MRI | Visceral to Subcutaneous fat storage ratio | Baseline | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Obesity, Pediatric