Copeptin and Nonalcoholic Fatty Liver Disease

February 9, 2021 updated by: University of Colorado, Denver
Copeptin, a surrogate marker for vasopressin, has been found to be elevated in metabolic disorders including obesity and diabetes, which are disorders both associated with nonalcoholic fatty liver disease (NAFLD), and therefore suggest a potential role for vasopressin in the pathogenesis of NAFLD. The investigators intend to investigate if there is an association of vasopressin with the presence and severity of NAFLD.

Study Overview

Status

Recruiting

Conditions

Detailed Description

Participants: As a pilot study, the investigators will recruit 30 obese adults with NAFLD based upon ultrasound echogenicity within 6 months of enrollment, and 30 obese adults without NAFLD based upon ultrasound (US) echogenicity for comparison.

Screening Visit/Study Visit: Patients in the investigator's Obesity clinic will be approached about the study and consented if interested at the screening. Participants will have a chart review for their history and physical Exam and medication review for inclusion and exclusion criteria. Qualified participants will be invited for a screening visit to be scheduled in conjunction with the labs and procedures performed as Standard of Care (SOC) in the obesity clinic. At the screening visit, following consent, participants will have vitals (blood pressure, Body Mass Index (BMI), waist circumference) and a physical examination performed. Participants' Standard of Care (SOC) labs including fasting lipid panel, HbA1c (unless done within last 3 months), comprehensive metabolic panel, titers for hepatitis b and c, and complete blood count will be drawn, along with the following research labs: insulin, glucagon, free fatty acids, adiponectin and a 24-hour urine cortisol collection. Those who have not had an abdominal US will have a SOC US performed to delineate non-NAFLD or NAFLD status. US will not be performed if already done within 6 months of enrollment. All ultrasound studies will be interpreted by one University of Colorado Denver radiologist to categorize the patient as NAFLD or non-NAFLD to limit inter-reader variability. Those with NAFLD present on US will also have a SOC Fibroscan done to assess severity of steatosis (based upon Controlled Attenuation Parameter or CAP Score) and fibrosis (based upon elastography). Given limitations of ultrasound to accurately detect significant steatosis unless >30%, the investigators will in addition perform Fibroscan (all particpants regardless of US) to assess steatosis, so as to confirm if significant steatosis and compare copeptin levels on a continuum of level of steatosis as part of research procedure. Fibroscan can detect steatosis (based upon Controlled Attenuation Parameter or CAP Score) and fibrosis (based upon elastography). FIbroscan with M probe has been found to have AUROC 0.823 for a cutoff of value of 248 dB/m for no steatosis vs steatosis (with other cutoffs at 268 dB/m between S1 and S2-S3 and 280 dB/m between S1-S2 and S3 disease).

Study Type

Observational

Enrollment (Anticipated)

60

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

    • Colorado
      • Aurora, Colorado, United States, 80045
        • Recruiting
        • University of Colorado
        • Contact:
          • Thomas Jensen, MD
          • Phone Number: 720-848-2650
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

30 years to 75 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

  1. Obese adults (BMI 30-40 kg/m2) age 30-75 years with NAFLD based upon ultrasound echogenicity within 6 months of enrollment
  2. Obese adults (BMI 30-40 kg/m2) age 30-75 years without NAFLD based upon ultrasound echogenicity within 6 months of enrollment

Description

Inclusion Criteria:

  1. Patients age 30-75
  2. BMI 30-40
  3. Presence of fatty liver on ultrasound

Exclusion Criteria:

  1. Diabetes mellitus (determined by prior HbA1c, fasting glucose, and/or random glucose in the last three months according to ADA criteria),
  2. Medication known to affect insulin sensitivity e.g. metformin, thiazolidinediones, systemic steroids, atypical antipsychotics),
  3. Fibrates,
  4. eGFR <45 ml/min/1.73m2 by MDRD equation(11),
  5. Pregnancy,
  6. Breast feeding,
  7. Sodium <135 mEq/L,
  8. Diabetes insipidus,
  9. Liver disease other than NAFLD (including obstructive liver disease),
  10. ALT or AST>60 IU/L,
  11. Hepatic steatosis on ultrasound for the non-NAFLD group,
  12. Congestive heart failure,
  13. Patients who consume >20g of ETOH a day,
  14. Patients found to have Cushing's disease based upon 24 hour urine results (Urine Free cortisol >2x upper limit of normal).
  15. Patient's with pacemakers
  16. Off of Coenzyme Q for 6 months.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Other
  • Time Perspectives: Cross-Sectional

Cohorts and Interventions

Group / Cohort
Obese with NAFLD
Patients who have NAFLD based upon ultrasound
Obese without NAFLD
Patients who do not have NAFLD based upon ultrasound

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Comparision of Copeptin with and without NAFLD
Time Frame: Within 6 months of documented NAFLD or non-NAFLD and within 1 week of fibroscan
The investigators will compare level of copeptin with the measurement of NAFLD based upon ultrasound and fibroscan.
Within 6 months of documented NAFLD or non-NAFLD and within 1 week of fibroscan
Copeptin and level of steatosis
Time Frame: Within one week of fibroscan being perfomed
Comparison of CAP score of fibroscan to copeptin levels
Within one week of fibroscan being perfomed
Copeptin and Liver Elastography
Time Frame: Within one week of fibroscan being perfomed
Compare Copeptin to liver elastography (kPa)
Within one week of fibroscan being perfomed

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Insulin Resistance and copeptin
Time Frame: Same day as these labs after 8 hour fast from food and water.
Changes in insulin, fasting glucose, HOMA-IR, HOMA-B, adiponectin estimated Insulin Compared to copeptin level
Same day as these labs after 8 hour fast from food and water.
Copeptin and Lipids
Time Frame: Same day as these labs after 8 hour fast from food and water.
Compare copeptin level to cholesterol and free fatty acids
Same day as these labs after 8 hour fast from food and water.
Copeptin and Liver enzymes
Time Frame: Same day as these labs after 8 hour fast from food and water.
Compare copeptin and liver enzymes
Same day as these labs after 8 hour fast from food and water.
Copeptin and Weight
Time Frame: Within 1 month of screening visit
Compare Copeptin with BMI
Within 1 month of screening visit
Copeptin and Waist Circumference
Time Frame: Within 1 month of screening visit
Compare copeptin with weight circumference
Within 1 month of screening visit
Copeptin and Blood pressure
Time Frame: Within 1 month of screening visit
Compare copetin with measurements of blood pressure
Within 1 month of screening visit

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Thomas Jensen, MD, University of Colorado, Denver

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 19, 2018

Primary Completion (Anticipated)

June 1, 2021

Study Completion (Anticipated)

June 1, 2021

Study Registration Dates

First Submitted

August 16, 2017

First Submitted That Met QC Criteria

August 16, 2017

First Posted (Actual)

August 18, 2017

Study Record Updates

Last Update Posted (Actual)

February 10, 2021

Last Update Submitted That Met QC Criteria

February 9, 2021

Last Verified

February 1, 2021

More Information

Terms related to this study

Other Study ID Numbers

  • 17-1160

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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