Clinical trial NCT01698502: Physical Training and the Incretin Effect
Official title: Does Physical Training Effect the Incretin Effect
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Healthy
Keywords: Incretin
Training
Glucagon like peptide
glucose dependent insulinotropic peptide
Gut
Exercise
Insulin
Focus:
Gut hormone
adaptations
Lead sponsor: University of Copenhagen
Sponsor class: OTHER
First posted: 2012-10-03
Enrollment: 21
Sex: MALE
Minimum age (years): 20
Maximum age (years): 30
Standard ages: ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CROSSOVER
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Danish University Students from University of Copenhagen,

Brief summary: It is well known that continuous physical exercise leads to a number of changes in the body. Maximal oxygen uptake; the heart's pumping ability and muscle mass and strength increases. Also the metabolism adapts: The ability to oxidize fat increase and the insulin sensitivity in primarily in muscle, but also in the liver increase.

Also endocrine glands adapts according to the level of physical activity. It is known that in healthy, younger people the insulin secretion from the pancreas after administration of sugar consumed orally or given directly into a vein, is significantly lower in trained individuals compared with untrained. This change does, however, not only apply to glucose, as also stimulation by the amino acid arginine, shows the same pattern.

It seems plausible that the endocrine glands/cells adapts to the level of physical training, but this has not yet been investigated.

The gastrointestinal tract is the birthplace of a variety of hormones. One group of these is called incretin hormones. They stimulate the glucose dependant insulin secretion in the pancreas and affect hunger/satiety. Whether the incretin production and thus their concentration in the blood is regulated by physical training is unknown.

Obese and patients with type 2 diabetes, has, in contrast to well-trained, decreased insulin sensitivity. As a consequence their (type 2 diabetics, at least early in their disease course) meal stimulated insulin release is greater than in healthy, normal weight individuals. This in spite of the fact that the incretin effect is reduced in obese people and patients with type 2 diabetes compared to healthy, normal weight.

Whether physical training affects both the secretion of incretins and the incretin effect has not yet been studied.

The purpose of this study is to investigate whether incretin hormones in physical well-trained young men have a changed effect on insulin secretion from the pancreas compared to untrained young men. A difference may indicate that the body's endocrine glands adapts to training mode.

The investigators hypothesis is that incretin hormones have a decreased effect on the glucose dependant insulin release in physically trained persons and thus results in a lower insulin release at any given plasma glucose level.


Eligibility criteria: Inclusion Criteria:

* Sedentary: 50\>Maximal oxygen uptake (VO2max), ml\*min-1\*kg-1 OR endurance trained VO2max, ml\*min-1\*kg-1\>60
* 20-30 years
* BMI: 18,5-25kg/m2
* Caucasian
* Healthy

Exclusion Criteria:

* Any kind of medication or diabetes in the family (parents, siblings),
* Non-caucasian

Primary outcomes:
measure: Incretin Effect (the % of Insulin Secreted Due to the Release of the Intestinal Hormones Glucagon Like Peptide-1 (GLP-1 and Glucose-dependent Insulinotropic Peptide (GIP))
timeFrame: Test day 1 and 2 within 7 days.
Secondary outcomes:
measure: The Total Glucose-dependent Insulinotropic Peptide (GIP) Response Measured as Area Under the GIP Curve (AUC GIP).
timeFrame: Test day 1 and 2 within 7 days.
Other outcomes:
Locations:
city: Copenhagen
country: Denmark
facility: University of Copenhagen, Faculty of Health Sciences
state: North
Study officials:
affiliation: University of Copenhagen, Dep. of Biomedical Sciences, Center of healthy Ageing, XLAB
name: Flemming Dela, Prof. MD
role: STUDY_CHAIR
References:
citation: Dela F, Handberg A, Mikines KJ, Vinten J, Galbo H. GLUT 4 and insulin receptor binding and kinase activity in trained human muscle. J Physiol. 1993 Sep;469:615-24. doi: 10.1113/jphysiol.1993.sp019833.
citation: Dela F, Mikines KJ, von Linstow M, Secher NH, Galbo H. Effect of training on insulin-mediated glucose uptake in human muscle. Am J Physiol. 1992 Dec;263(6):E1134-43. doi: 10.1152/ajpendo.2006.263.6.E1134.
citation: Mikines KJ, Sonne B, Farrell PA, Tronier B, Galbo H. Effect of training on the dose-response relationship for insulin action in men. J Appl Physiol (1985). 1989 Feb;66(2):695-703. doi: 10.1152/jappl.1989.66.2.695.
citation: Dela F, Mikines KJ, Von Linstow M, Galbo H. Effect of training on response to a glucose load adjusted for daily carbohydrate intake. Am J Physiol. 1991 Jan;260(1 Pt 1):E14-20. doi: 10.1152/ajpendo.1991.260.1.E14.
citation: King DS, Dalsky GP, Staten MA, Clutter WE, Van Houten DR, Holloszy JO. Insulin action and secretion in endurance-trained and untrained humans. J Appl Physiol (1985). 1987 Dec;63(6):2247-52. doi: 10.1152/jappl.1987.63.6.2247.
citation: Mikines KJ, Sonne B, Tronier B, Galbo H. Effects of training and detraining on dose-response relationship between glucose and insulin secretion. Am J Physiol. 1989 May;256(5 Pt 1):E588-96. doi: 10.1152/ajpendo.1989.256.5.E588.
citation: Dupre J, Ross SA, Watson D, Brown JC. Stimulation of insulin secretion by gastric inhibitory polypeptide in man. J Clin Endocrinol Metab. 1973 Nov;37(5):826-8. doi: 10.1210/jcem-37-5-826. No abstract available.
citation: Holst JJ, Orskov C, Nielsen OV, Schwartz TW. Truncated glucagon-like peptide I, an insulin-releasing hormone from the distal gut. FEBS Lett. 1987 Jan 26;211(2):169-74. doi: 10.1016/0014-5793(87)81430-8.
citation: Nauck MA, Heimesaat MM, Orskov C, Holst JJ, Ebert R, Creutzfeldt W. Preserved incretin activity of glucagon-like peptide 1 [7-36 amide] but not of synthetic human gastric inhibitory polypeptide in patients with type-2 diabetes mellitus. J Clin Invest. 1993 Jan;91(1):301-7. doi: 10.1172/JCI116186.
citation: Knop FK, Aaboe K, Vilsboll T, Volund A, Holst JJ, Krarup T, Madsbad S. Impaired incretin effect and fasting hyperglucagonaemia characterizing type 2 diabetic subjects are early signs of dysmetabolism in obesity. Diabetes Obes Metab. 2012 Jun;14(6):500-10. doi: 10.1111/j.1463-1326.2011.01549.x. Epub 2012 Jan 17.