The IMAGE Research Group is pleased to introduce two new studies: POEM, which looks at treating mild cognitive impairment, and BLAST, a study delving into the causes for arterial stiffness in estrogendeficient postmenopausal women. Also, SAVE THIS DATE: the IMAGE Research Group’s Holiday Party will be held on Tuesday, December 2, from 4pm- 7pm. We hope to see you there!

For access to more of the IMAGE group’s research publications visit: www.uchsc.edu/image. Click on “Faculty” and then select a faculty member. Click on “Pubmed Publications” to view each researcher’s recently published abstracts.

Pioglitazone Or Exercise to Treat Mild Cognitive Impairment:

POEM will examine whether a study drug, Pioglitazone, or exercise training can improve memory function in older adults.

Alzheimer’s Disease is the 6th leading cause of death in the U.S. Due to the urgency of finding effective treatments, one key research strategy is focusing on prevention by identifying people who are at an increased risk of developing Alzheimer’s. The pre-dementia state, called Mild Cognitive Impairment (MCI), includes people with mild memory problems such as difficulty recalling information about themselves or family members but who are also able to function independently. Although not everyone with MCI develops Alzheimer’s, people with MCI are 5-10 times more likely to develop dementia compared to non-MCI individuals.

Evidence has also shown an association between Alzheimer’s Disease and Metabolic Syndrome (MetSyn). MetSyn includes high blood pressure, abnormal blood lipid levels (high triglycerides and low high density cholesterol), abdominal obesity (large waist size), and high blood sugar. Insulin resistance is problematic in individuals who have Met- Syn, meaning their bodies do not respond to insulin as they should. Insulin is an important hormone for controlling blood sugar levels, but also helps the brain to function normally.

POEM will attempt to answer whether treating MetSyn in people who also have MCI could delay or prevent the progression to Alzheimer’s Disease. The goal of this research study is to determine whether improving insulin metabolism, using Pioglitazone or cardiovascular exercise, can help slow declines in memory function compared to those who are not treated.

Robert Schwartz, MD, is the Principal Investigator for this study. For additional eligibility requirements or further information, please contact Erica Borresen at 720-848-6376. (COMIRB # 07-1215)

What Causes Arteries to Become Unhealthy in Estrogen-Deficient Postmenopausal Women?:

The BLAST study (BH4 , Inflammation, and Large Artery Stiffening in Women) is looking to answer the above question. As women age and go through menopause the arteries located around the heart get stiffer. This stiffness can lead to health problems, such as high blood pressure and heart disease. The reasons why arteries stiffen with aging and menopause are unclear.

The BLAST study will be examining different factors that could cause arteries to become stiffer in women with low levels of estrogen. Specifically, the study will determine if arteries are stiffer in postmenopausal women compared to premenopausal women because of differences in two natural substances in the body: BH4 (tetra hydrobiopterin) and TNF-a (tumor necrosis factor - alpha).

BLAST will determine whether arteries are stiffer in postmenopausal women because they have too little BH4 and/or too much TNF-a levels. This will be studied by giving participants a BH4 supplement and a medication to decrease TNF-a levels. In addition, some postmenopausal women will be given estrogen to bring levels back up to normal. Women will have a series of screening tests to see if they qualify for the study, including a blood test and a history and physical with the study physician. Ultrasound tests to measure the stiffness of their arteries will be performed twice for premenopausal women and three times for postmenopausal women.

Eligible women are premenopausal (18-40 years) or postmenopausal (50-65 years), nonsmokers with normal blood pressure, not currently taking birth control or hormone therapy, and not exercising vigorously more than 2 days per week. Kerrie Moreau, PhD is the Principal Investigator for this study. For further information, please contact Lauren Tobin at 720-848-7561 or Lauren.Tobin@uchsc.edu. (COMIRB # 07-1097)

• The MOXI Study is examining how the use of ibuprofen in older, exercising women and men affects muscle and bone health. Eligible participants are 60-75 years of age who are not currently in a weight lifting program, have no history of peptic ulcers or stomach bleeding, and do not typically use acetaminophen, ibuprofen, or similar drugs more than 3 days per month. (COMIRB #06-0769)
• The DRIFT study is comparing the effect of two different diet methods - a normal, low calorie diet or intermittent fasting (not eating or drinking anything with calories every other day) - on weight loss and other health measures. Eligible participants are women and men, 18-55 years, who are obese based on a body mass index (BMI) ≥30 (to determine your BMI go to www.nhlbisupport.com/bmi). (COMIRB # 06-0383)
• The POEM Study is examining whether 6 months of cardiovascular exercise training or a study drug (Pioglitazone) can improve memory function. Eligible participants are healthy adults over the age of 55 years who are experiencing mild memory problems, are slightly overweight and considered pre-diabetic, non-smokers, and not regularly exercising. (COMIRB # 07-1215)
• The Lose-It Study will investigate the amount of exercise that health care providers should prescribe in order for patients to maintain weight loss. Eligible participants are healthy men and women between 18-45 years of age. Participants must be willing to engage in lifestyle changes including diet modifications and up to 100 minutes of daily physical activity. (COMIRB # 06-0369)
• The Minimally Invasive Total Knee Replacement Study looks at different surgical approaches for total knee replacement and combines these with a progressive rehabilitation program. Eligible adults are 50 to 85 years of age and are candidates for knee replacement surgery with Dr. Michael Dayton at the University of Colorado Hospital. (COMIRB #06-0183)
• The Rehabilitation for Total Knee Replacement Study is investigating 2 rehabilitation programs designed to restore muscle strength more effectively to improve function with daily activities. Eligible adults are 50 to 85 years of age and are candidates for knee replacement surgery. (COMIRB #06-0074)

• The POWER Study is examining the role of the female sex hormone estrogen in preventing excess fat gain in women. Eligible participants are healthy women aged 20-40, who have regular menstrual cycles, and are not currently using hormonal contraceptives. (COMIRB #06-0512)
• The FLARE Study is examining how leg and hip liposuction surgery affects fat metabolism and cardiovascular health. Eligible participants are healthy pre- or postmenopausal women aged 40-55 years who are good candidates for leg and hip liposuction surgery and not using oral contraceptives or hormone therapy. (COMIRB #07-0339)

• The SHAPE study is examining how short-term changes in estrogen affect cardiovascular health. Eligible participants are premenopausal women 21-35, perimenopausal women 40-55, and postmenopausal women 45-70 years, who are non-smokers, have normal blood pressure, and who are not taking birth control or hormone therapy. (COMIRB # 06-0537)
• The MUSE study is investigating the effects of estrogen on changes in muscle due to lack of use. Eligible participants are women aged 21-40, who have regular menstrual cycles, are not currently using hormonal contraceptives, are physically active but not competitive athletes, and willing to wear a knee brace and use crutches for 9 days. (COMIRB #07-0379)
• The SCALE study is examining the role of the sex hormone estrogen and weight loss on the metabolism of the stress hormone cortisol. Eligible participants are overweight/ obese but otherwise healthy, non-smoking postmenopausal (40-59 years), not currently on hormone replacement, and willing to take part in a 1 month estrogen therapy study followed by a 4 month supervised exercise program to lose weight. (COMIRB #07-0278)

• The TEAM study is examining the effects of testosterone supplementation and exercise in men who have low-normal testosterone levels. Eligible participants are men, 60 years and older, non-smokers, in good general health, and not currently doing high-intensity weight lifting exercise. (COMIRB # 02-1056)
• The Mr. ACET study is examining how the use of acetaminophen and ibuprofen in older, exercising men, affects muscle and bone health. Eligible participants are men, 60 years and older, who are not currently in a weight lifting program, have no history of peptic ulcers or stomach bleeding, and do not typically use acetaminophen, ibuprofen, or similar drugs more than 3 days per month. (COMIRB # 06-0343)
• The PROXI study is determining if weight lifting helps to prevent the loss of muscle and bone mass that occurs in men with prostate cancer on androgen deprivation therapy (ADT). Eligible participants are men, 45-85 years, with prostate cancer, who are taking ADT or plan to start ADT. (COMIRB #02-958)