Mineralocorticoid Receptor and Obesity Induced Cardiovascular Complications
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02115
- Brigham and Women's Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age 18-70 years
- Good health as evidenced by history and physical exam
- Body Mass Index (BMI): >30 kg/m2 and <45 kg/m2
Exclusion criteria:
- Medical illnesses other than treated hypothyroidism
- Blood Pressure (BP) >135/85 or systolic BP <90 mm Hg
- Hepatic disease (transaminase > 3 times normal)
- Renal impairment (Creatinine clearance <60 ml/min)
- Baseline serum Potassium (K) >5.0 mmol/L
- History of drug or alcohol abuse
- Allergies to spironolactone
- Participation in any other concurrent clinical trial
- Women using oral contraceptives within the last 3 months
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Placebo
|
Placebo-matching spironolactone once daily for 6 weeks.
|
|
Active Comparator: Spironolactone
|
50 mg once daily for 6 weeks.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change From Baseline in Post-ischemic Dilatation
Time Frame: Baseline and Week 6
|
Ultrasonography of the brachial artery was performed to evaluate endothelial function by flow mediated dilatation (FMD) studies.
A blood pressure cuff was placed on the participant's upper arm and was compressed for 5 minutes.
After release of compression, brachial artery diameter and blood flow velocity were measured.
FMD was expressed as the percentage change in brachial artery diameter.
A positive change from Baseline indicates improvement.
|
Baseline and Week 6
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change From Baseline in Para-aminohippurate (PAH) Clearance
Time Frame: Baseline and Week 6 (Prior to PAH infusion and at 50 and 60 minutes post PAH infusion)
|
Renal plasma blood flow was determined by clearance of para-aminohippurate (PAH).
A loading dose of PAH (8 mg/kg) was given intravenously followed by a 1 hour constant infusion of PAH at a rate of 12 mg/minute (min).
Plasma samples were obtained at Baseline and at 50 and 60 minutes.
PAH clearance was calculated from the plasma levels and infusion rates and reported in millimeters (mL)/minute (min).
A positive change from Baseline indicates improvement.
|
Baseline and Week 6 (Prior to PAH infusion and at 50 and 60 minutes post PAH infusion)
|
|
Change From Baseline in Markers of Inflammation
Time Frame: Baseline and Week 6
|
Blood was to be collected and tested for Tumor Necrosis Factor Alpha (TNF-α) and Monocyte Chemotactic Protein-1 (MCP-1), markers of inflammation; However, due to lack of funding, blood samples were not analyzed and data for levels of inflammation markers were not collected.
|
Baseline and Week 6
|
|
Change From Baseline in Insulin Sensitivity Index (ISI)
Time Frame: Baseline and Week 6 (Prior to ingesting glucose and every 30 minutes for 120 minutes)
|
Insulin sensitivity was measured using the 75 gram (G) glucose tolerance test.
Participants ingested 75 grams of glucose in 300-400 milliliters (mL) of water over 5 minutes.
Blood samples were taken before ingesting glucose and then every 30 minutes for 120 minutes.
Insulin sensitivity index was calculated by Matsuda and Defronzo's formula using the values obtained.
A positive change from Baseline (increase in insulin sensitivity) indicates improvement.
|
Baseline and Week 6 (Prior to ingesting glucose and every 30 minutes for 120 minutes)
|
|
Change From Baseline in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)
Time Frame: Baseline and Week 6 (Prior to ingesting glucose and every 30 minutes for 120 minutes)
|
Insulin resistance was measured using the 75 G glucose tolerance test.
Participants ingested 75 grams of glucose in 300-400 mL of water over 5 minutes.
Blood samples were taken before ingesting glucose and then every 30 minutes for 120 minutes.
HOMA-IR was calculated using the Insulin and glucose levels obtained.
A negative change (decrease in insulin resistance) indicates improvement.
|
Baseline and Week 6 (Prior to ingesting glucose and every 30 minutes for 120 minutes)
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Brown JM, Williams JS, Luther JM, Garg R, Garza AE, Pojoga LH, Ruan DT, Williams GH, Adler GK, Vaidya A. Human interventions to characterize novel relationships between the renin-angiotensin-aldosterone system and parathyroid hormone. Hypertension. 2014 Feb;63(2):273-80. doi: 10.1161/HYPERTENSIONAHA.113.01910. Epub 2013 Nov 4.
- Garg R, Kneen L, Williams GH, Adler GK. Effect of mineralocorticoid receptor antagonist on insulin resistance and endothelial function in obese subjects. Diabetes Obes Metab. 2014 Mar;16(3):268-72. doi: 10.1111/dom.12224. Epub 2013 Oct 31.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Glucose Metabolism Disorders
- Metabolic Diseases
- Overnutrition
- Nutrition Disorders
- Overweight
- Body Weight
- Hyperinsulinism
- Obesity
- Insulin Resistance
- Physiological Effects of Drugs
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Natriuretic Agents
- Diuretics
- Hormone Antagonists
- Mineralocorticoid Receptor Antagonists
- Diuretics, Potassium Sparing
- Spironolactone
Other Study ID Numbers
Other Study ID Numbers
- 2009P-000311
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