Neural Functioning of Feeding Centers in Obese Youth

Study Overview
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Brief Summary
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To explore whether obese adolescents with insulin resistance and relative low leptin levels exhibit functional alterations of the neuronal circuits involved in the regulation of energy metabolism and food seeking behaviors. We here propose to test the hypothesis that the reward circuitry is dysregulated in obese adolescents and is related to the degree of insulin resistance and hyperinsulinemia.

Detailed Description
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Functional Magnetic Resonance Imaging (fMRI) provides a non-invasive method to assess the functional pathways affected by nutrient ingestion and therefore can help answer important questions regarding potential differences in the response of brain regions involved in feeding.

Official Title
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Neural Functioning of Feeding Centers in Obese Youth

Conditions
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Obesity, Insulin Resistance

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Obese adolescents Good general health, taking no medication on a chronic basis Age 12 to 17 yrs, in puberty (girls and boys: Tanner stage II - IV) Obese Insulin Resistant Adolescents (BMI> 95th) (WBISI<1.2 plus a low adiponectin <6 ug/dl and high triglyceride levels >130mg/dl) Obese Insulin Sensitive Adolescents (BMI>95th) (WBISI >3) plus high adiponectin >8 ug/ml and triglyceride levels > 80 mg/dl Girls who begin menstruating must have a negative pregnancy test during the study Eligibility criteria for healthy non-obese children and adolescents: Brother or sister with obesity Age 12 to 17 years Normal fasting glucose and lipids in the child, and normal OGTT No use of any medication known to affect glucose, lipid metabolism and inflammation No endocrinopathies No use of any antipsychotic medication BMI >25th to <75th ( Center for Disease Control (CDC) BMI Charts) Minimum weight of 90lbs (CDC Growth Charts) Exclusion Criteria Baseline creatinine >1.0 mg Pregnancy Presence of endocrinopathies (e.g. Cushing syndrome) Cardiac or pulmonary or other significant chronic illness Adolescents with psychiatric disorder or with substance abuse determined via self-report. Use of anorexic agents No metal implants

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Lean Adolescents<br>Kids aged 12-17 with body mass index less than 25% and normal glucose tolerance test results | |
| Obese Insulin Sensitive<br>Obese Insulin Sensitive Adolescents aged 12-17 with BMI>95th% and whole body insulin sensitivity index > 3. | |
| Obese Insulin Resistant Adolscent<br>Obese Insulin Resistant Adolescents 12-17 with BMI> 95th% and WBISI<1.2. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| measure of cerebral blood flow response to glucose ingestion | fmri on 3T to measure blood flow response after ingestion of glucose drink | Baseline and 2 year follow up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| measure of cerebral blood flow response to fructose ingestion | fmri on 3T to measure blood flow response after ingestion of fructose drink | Baseline and 2 year follow up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Obesity, Insulin Resistance, functional magnetic resonance imaging, glucose, fructose, hypothalamus, neuronal circuits, feeding behavior