Corticosteroid-induced Lipodystrophy and Adipokines (ADIPOKINES)

February 26, 2014 updated by: Assistance Publique - Hôpitaux de Paris

Study of Histological and Adipokines Expression Variations in Lipodystrophic Adipose Tissue During Corticosteroids-induced Lipodystrophy

Hypothesis: systemic therapy with corticosteroid induces morphological changes (e.g., moon face, buffalo neck) called lipodystrophy (LD). We hypothesize that this LD is associated with variation of adipocytokines (e.g., adiponectin, leptine, IL6) levels

Primary objective: To show a 50% decrease in adipocytes adiponectin's expression in patients who developed LD versus those who did not developed LD during the first 3 months of a systemic therapy with corticosteroids

Secondary objectives: To look for differences in the mRNA expression of 11bHSD1, SREBP1c and PPARg in fat samples of patients before and after treatment with systemic corticosteroids and between LD+ and LD-patients To compare the fat morphology before and after treatment with glucosteroids

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Design: Monocentric, cross-sectional analytical study

Subjects: 32 HIV-free and Cushing disease-free adult patients for whom a prolonged treatment (³3months) with glucosteroids (³ 0.5 mg/kg/day) is initiated

Methods: At treatment initiation and 3 months after: comparison of fat sample mRNA expression of adipokines (adiponectin, leptin, IL6, TNFa), 11bHSD1, SREBP1c and PPARg, fat morphology and seric concentrations of adiponectin, leptin, IL6, sTNFR1 between patients LD+ and patients LD-. The diagnosis of LD will be performed by 3 experts using patients photographs

Aims of this study:

  • To gain a better understanding of the pathophysiology of glucosteroids-induced LD
  • To compare this pathophysiology to the one of HIV-associated LD for which the hypothesis of a local, cellular, hypercorticism has been put forward and for which related treatment have been prescribed.

Study Type

Observational

Enrollment (Actual)

32

Contacts and Locations

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

Study Locations

      • Paris, France, 75012
        • Hopital Saint-Antoine

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

16 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Patients consulting in participating units

Description

Inclusion Criteria:

  • adult patient
  • starting therapy with prednisone
  • corticosteroid therapy lasting more than 3 months
  • baseline prednisone dosage >= 0.5 mg/kg/d

Exclusion Criteria:

  • Cushing disease
  • HIV +Pregnancy
  • Recent weight lost (> 5% of the usual weight)
  • Therapy with glucocorticosteroids during the past 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: Cohort
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
1
Patients with corticotherapy lasting more than 3 months
  • Scanner, histomorphometry : at the inclusion and M3 visits
  • whole blood samples, cytoponction : at the inclusion and M3 visits

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Expression of adiponectin in adipocytes
Time Frame: at the inclusion and M3 visits
at the inclusion and M3 visits

Secondary Outcome Measures

Outcome Measure
Time Frame
Plasma levels of adiponectin, leptin, sTNFR1, and IL6
Time Frame: at the inclusion and M3 visits
at the inclusion and M3 visits
Histological morphology of adipocytes
Time Frame: at the inclusion and M3 visits
at the inclusion and M3 visits
Expression of leptin, IL6, TNFa, 11bHSD1, SREBP1c and PPARg in adipocytes
Time Frame: at the inclusion and M3 visits
at the inclusion and M3 visits

Collaborators and Investigators

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

Investigators

  • Principal Investigator: Laurence FARDET, MD PhD, Assistance Publique - Hôpitaux de Paris

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

August 1, 2006

Primary Completion (Actual)

October 1, 2008

Study Completion (Actual)

November 1, 2008

Study Registration Dates

First Submitted

January 13, 2009

First Submitted That Met QC Criteria

January 13, 2009

First Posted (Estimate)

January 14, 2009

Study Record Updates

Last Update Posted (Estimate)

February 27, 2014

Last Update Submitted That Met QC Criteria

February 26, 2014

Last Verified

January 1, 2009

More Information

Terms related to this study

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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