ClinicalTrials.gg
TerminatedNCT05743868Updated Oct 27, 2026

Metabolic Heterogeneity Underlying Hypertriglyceridemia: Hepatic Triglyceride Biosynthesis in Humans With Different Insulin Resistance Phenotypes

An interventional study of Standardized Dinner and Premeal exercise in Insulin Resistance and Hypertriglyceridemia, sponsored by Yale University. Terminated at 1 site in Netherlands. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-10-27.

Sponsored by Yale University · Not applicable, Interventional, and Basic science

Why this study was terminated
Poor accrual and lack of funding
Updated Oct 27, 2026Now TerminatedEnrollment updatedGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
8
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

The focus of this cross-sectional study is to determine the effects of tissue-specific (adipose tissue or muscle) vs global (combined) insulin resistance (IR) on hepatic triglyceride biosynthesis in humans, and to determine differential effects of an acute exercise intervention on hepatic triglyceride biosynthesis in these groups.

Read the detailed description

Hypothesis: Patients who primarily have muscle IR will have a greater percentage of lipids derived from de novo lipogenesis (DNL) than patients with combined muscle and adipose IR, and these subjects will respond more robustly to the effects of premeal exercise.

With this study, the investigators will demonstrate that the mechanisms that drive triglyceride overproduction in insulin-resistant humans are dependent on which tissues are insulin resistant. To this end, investigators will determine whether subjects with muscle insulin resistance and adipose tissue insulin resistance utilize different mechanisms of triglyceride biosynthesis to assemble hepatic very low density lipoprotein (VLDL), as compared with individuals with muscle insulin resistance but relative adipose tissue insulin sensitivity. Additionally, investigators will see if adipose tissue insulin sensitivity predicts exercise responsiveness of hepatic triglyceride production.

Main study parameters/endpoints: Difference in %DNL between subjects with global vs muscle-only insulin resistance as well as the differential effects of premeal exercise on %DNL in these groups.

02

Conditions studied

  • Insulin Resistance
  • Hypertriglyceridemia
03

In context

Insulin Resistance

2,969 studies on the registry are indexed under Insulin Resistance; 338 are open to participants now.

This study's enrollment of 8 is below the median of 40 across 2,369 interventional studies indexed under Insulin Resistance.

Browse Insulin Resistance studies →

Lead sponsor

Yale University is the lead sponsor of 1,770 studies on the registry; 294 are open to participants now.

Of its 221 completed or terminated interventional studies of FDA-regulated products, 129 (58%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Ability to give
  • Overweight, defined as 25-30 kg/m2
  • Modest hypertriglyceridemia, defined as fasting plasma triglycerides 1.5-3.0mM
  • High risk of insulin resistance, defined as fasting plasma insulin >64pM
  • Stable weight for at least 3mo prior to participation

Exclusion criteria

Exclusion Criteria:

  • Active or chronic liver disease, kidney disease, congestive heart failure, unstable angina, history of acute cardiovascular events within 6mo of screening, history of seizures or syncope, or an active infection requiring antimicrobial therapy;
  • Use of insulin, thiazolidinediones, SGLT2 inhibitors, or sulfonylureas;
  • Use of fibrates, omega 3 (fish oil), niacin, or PCSK9 antagonists;
  • Use of systemic within 60d prior to participation;
  • Hematocrit \<35%;
  • Pregnancy of breastfeeding;
  • Active tobacco use, excessive alcohol intake (>14U/wk), or history of drug abuse.
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

05

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Randomized
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
8 participants (actual)

Study arms

  • Experimental
    IR participants with standardized dinner

    Participants with global IR and tissue-specific IR. Participants with global IR (in both skeletal muscle and adipose tissue) and tissue-specific IR (in adipose tissue). Glucose tolerance, skeletal muscle/whole-body insulin sensitivity and adipose tissue insulin sensitivity will be evaluated prior to intervention. Contribution of DNL to hepatic VLDL will be measured using a deuterated water drink, to be ingested prior to the standardized dinner. Blood will be drawn the following morning for the measurement of deuterium incorporation into triglycerides. Plasma deuterium will be allowed to wash out over several weeks, and the 2nd deuterated water study will be performed.

    Behavioral: Standardized Dinner

  • Experimental
    IR participants with standardized dinner and premeal exercise

    Participants with global IR and tissue-specific IR. Participants with global IR (in both skeletal muscle and adipose tissue) and tissue-specific IR (in adipose tissue). Glucose tolerance, skeletal muscle/whole-body insulin sensitivity and adipose tissue insulin sensitivity will be evaluated prior to intervention. DNL will be assessed in all participants after a single day with short bouts of premeal exercise with a standardized dinner. Contribution of DNL to hepatic VLDL will be measured using a deuterated water drink, to be ingested prior to the standardized dinner. Blood will be drawn the following morning for the measurement of deuterium incorporation into triglycerides. Plasma deuterium will be allowed to wash out over several weeks, and the 2nd deuterated water study will be performed.

    Behavioral: Standardized Dinner · Behavioral: Premeal exercise

Interventions

  • BehavioralStandardized Dinner

    De novo lipogenesis (DNL) will be assessed in all participants with a standardized dinner

  • BehavioralPremeal exercise

    DNL will be assessed in all participants with short bouts of premeal exercise with a standardized dinner

06

What researchers measure

Primary outcomes

  1. Effect of tissue-specific insulin resistance on contribution of DNL to plasma triglyceride

    The amount of de novo lipogenesis (DNL) in VLDL-triglycerides after a standard meal will be measured in plasma from whole blood. Relationship between DNL and 1) whole body (skeletal muscle) insulin resistance and 2) white adipose tissue insulin resistance will be assessed individually.

    Time frame: Baseline

  2. Change in DNL in VLDL-triglycerides after a standard meal compared to a standard meal with premeal exercise.

    The amount of de novo lipogenesis (DNL) in VLDL-triglycerides after a standard meal vs after a standard meal with premeal exercise will be measured in plasma from whole blood.

    Time frame: study visit 1 and study visit 2, up to 8 weeks

Secondary outcomes

  1. Change in plasma triglycerides after a standard meal compared to a standard meal with premeal exercise

    Plasma triglycerides will be measured under both conditions.

    Time frame: study visit 1 and study visit 2, up to 8 weeks

  2. Baseline plasma triglycerides

    Plasma triglycerides will be measured at the screening visit to determine eligibility for the study

    Time frame: baseline

  3. Adipose insulin sensitivity

    Both nonesterified fatty acids and insulin will be measured in the plasma at baseline to calculate Adipo-IR, a measure of adipose tissue insulin sensitivity.

    Time frame: Baseline

  4. Skeletal muscle/whole-body insulin sensitivity assessed by oral glucose tolerance test (OGTT)

    Matsuda index will be used to evaluate whole body physiological insulin sensitivity from the data obtained by OGTT. Insulin sensitivity as calculated by the Matsuda index: \[10,000 / √glucose minute 0 x insulin minute 0) (mean glucose (OGTT) x mean insulin OGTT)\]. A higher result indicates less IR.

    Time frame: Baseline

07

Study locations

1 site
  • AMC Amsterdam
    Amsterdam, Netherlands
08

References and documents

Individual participant data

Plan to share: Yes — By reasonable request, PI can be reached by email, and individual participant data (OGTT results, fasting plasma data, DNL data) will be provided electronically.

Time frame: Data will be available when data collection ends until 36 months after publication.

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Status
Recruiting→Terminated Poor accrual and lack of funding
changed Oct 27, 2026
Enrollment
40 (estimated)→8 (actual)
Oct 27, 2026
Show all 1 update
  1. Oct 27, 2026
    Recruiting→Terminated
    Why stopped Poor accrual and lack of funding
    Enrollment 40 (estimated)→8 (actual)
    + 4 other changes: verification date, date precision, contact details and site details

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT05743868
Lead sponsor
Yale University
Responsible party
Sponsor
First posted
Feb 24, 2023
Start date
Nov 16, 2023
Primary completion
Jun 24, 2026
Completion
Jun 24, 2026
Last update
Oct 27, 2026

Study contacts

Daniel F Vatner, MD, PhD
principal investigator · Yale University

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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