- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00922688
Dipeptide Alanyl Glutamine and Postoperative Insulin Resistance in Colon Carcinoma Patients (AIRCo)
Rationale: It is well known that insulin resistance occurs after mediocre and intensive surgery, such as colon cancer surgery. Disturbances in insulin action negatively affect the postoperative recovery, either by prolonging the capacity of the body to regain normal function, or by increasing the metabolic stress and the risk for complications. Several studies have shown that focusing therapies on improving insulin resistance is successful. Experimental studies have shown that antioxidant agents, like glutamine (a precursor of glutathione), improve insulin sensitivity. The hypothesis of this study is that perioperative parenteral or enteral administration of glutamine, given as the dipeptide alanyl-glutamine, will reduce or prevent postoperative insulin resistance in colon cancer patients. The study will also be focused on the different routes of administration, because of the expected differential metabolic effects.
Objective: The investigators' primary objective is to study whether intravenous or enteral administration of the dipeptide alanyl-glutamine will reduce or prevent postoperative insulin resistance in colon cancer patients.
Study design: A double-blinded, placebo controlled randomised, pilot study at the Surgery Department of the Medical Center Alkmaar.
Study population: Thirty patients of male gender and any ethnicity, who will undergo elective open abdominal colon surgery for colon cancer, aged 18-75 years.
Intervention: Patients will receive dipeptide alanyl-glutamine intravenously or enterally, starting 24 hours prior to surgery, until 24 hours after surgery in the dosage of 0.5 g/kg/day, or saline (control group), for the same period of time.
Main study parameters/endpoints: The main study parameter is postoperative insulin resistance. Secondary study parameters are lipolysis, oxidative stress and glucoregulatory hormones. Muscle, liver and fat biopsies will be taken to study insulin sensitive as well as inflammatory pathways.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Hamit Cakir, MD
- Phone Number: 0031725484444
- Email: h.cakir@mca.nl
Study Locations
-
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Noord holland
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Alkmaar, Noord holland, Netherlands, 1815 JD
- Recruiting
- Medical Center Alkmaar
-
Contact:
- Hamit Cakir, MD
- Phone Number: 0031725484444
- Email: h.cakir@mca.nl
-
Principal Investigator:
- Alexander PJ Houdijk, MD, PhD
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Sub-Investigator:
- Hamit Cakir, MD
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age between 18 and 75 years
- Colon cancer patients scheduled for elective open abdominal surgery
- Capable of giving informed consent
Exclusion Criteria:
- Patients who are participating in another clinical trial
- Unable to receive oral intake
- Major malabsorption disorder of the gut
- Patients with diabetes mellitus
- BMI above 30 kg/m2
- Use of certain medication: thyroid medication, corticosteroids, diuretic medication
- Known bleeding disorders or increased PTT and or APTT
- Any medical condition except for colon cancer
Study Plan
How is the study designed?
Design Details
- Primary Purpose: PREVENTION
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: TRIPLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Dipeptiven Arm Enteral
|
Intravenous supplementation of the dipeptide alanyl-glutamine is started 24 hours prior to surgery (dosage glutamine: 0,5 g/kg/day, and continued 24 hours postoperatively.
Enteral supplementation of the dipeptide alanyl-glutamine is started 24 hours prior to surgery (dosage glutamine: 0,5 g/kg/day, and continued 24 hours postoperatively.
|
Placebo Comparator: Placebo Arm Enteral and Intravenously
|
Intravenous and enteral supplementation of placebo is started 24 hours prior to surgery and continued 24 hours postoperatively.
|
Active Comparator: Dipeptiven ARM Intravenously
|
Intravenous supplementation of the dipeptide alanyl-glutamine is started 24 hours prior to surgery (dosage glutamine: 0,5 g/kg/day, and continued 24 hours postoperatively.
Enteral supplementation of the dipeptide alanyl-glutamine is started 24 hours prior to surgery (dosage glutamine: 0,5 g/kg/day, and continued 24 hours postoperatively.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
The effect of intravenously and enterally administered dipeptide alanyl-glutamine preoperatively on postoperative insulin resistance in colon cancer patients.given, on postoperative insulin resistance in colon cancer patients.
Time Frame: Before and 1 day after surgery
|
Before and 1 day after surgery
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
The effect of the dipeptide alanyl-glutamine on components of the insulin signalling cascade in muscle tissue.
Time Frame: Before and 1 day after surgery
|
Before and 1 day after surgery
|
The effect of the dipeptide alanyl-glutamine on the systemic inflammatory response as well as on inflammatory pathways in muscle.
Time Frame: Before and 1 day after surgery
|
Before and 1 day after surgery
|
The effect of the dipeptide alanyl-glutamine on the amino acid concentration in muscle tissue.
Time Frame: Before and 1 day after surgery
|
Before and 1 day after surgery
|
The effect of the dipeptide alanyl-glutamine on antioxidant/oxidant parameters in the circulating compartment.
Time Frame: Before and 1 day after surgery
|
Before and 1 day after surgery
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The effect of dipeptide alanyl-glutamine on the inflammatory response in the liver
Time Frame: During surgery
|
During surgery
|
The effect of dipeptide alanyl-glutamine on lipolysis.
Time Frame: Before and 1 day after surgery
|
Before and 1 day after surgery
|
The effect of dipeptide alanyl-glutamine on key enzymes involved in glucose production.
Time Frame: Before and 1 day after surgery
|
Before and 1 day after surgery
|
Collaborators and Investigators
Sponsor
Investigators
- Study Director: Alexander PJ Houdijk, MD,PhD, MCA Alkmaar
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Digestive System Diseases
- Glucose Metabolism Disorders
- Metabolic Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms by Site
- Neoplasms, Glandular and Epithelial
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Gastrointestinal Diseases
- Colonic Diseases
- Intestinal Diseases
- Intestinal Neoplasms
- Hyperinsulinism
- Colorectal Neoplasms
- Carcinoma
- Insulin Resistance
- Colonic Neoplasms
Other Study ID Numbers
- AIRCo05.02.2009/2
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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