Early Vascular Wall Changes by Magnetic Resonance Imaging (MRI) in Metabolic Syndrome Versus Metabolically Normal Pre-Menopausal Women: A Pilot Study

Early Vascular Wall Changes by MRI in Metabolic Syndrome vs. Metabolically Normal Pre-Menopausal Women: A Pilot Study

The purpose of this study is to compare the vascular permeability of blood vessel walls (of the carotid artery) in pre-menopausal women who have metabolic syndrome (syndrome of having at least 3/5 following features- increased abdominal fat, low good cholesterol (HDL-C), elevated fasting blood fats (triglycerides), elevated blood pressure, an elevated fasting glucose) versus those women who are normal weight and with normal cholesterol, blood fats, blood pressure, and blood sugar. We are using a novel technology to measure vascular permeability known as dynamic contrast enhancement magnetic resonance imaging (DCE-MRI). The primary variable is ktrans ratio which is a mathematically derived quantity obtained from DCE-MRI. We are trying to identify novel markers of early atherosclerosis in young women.

Study Overview

• Status: Unknown
• Conditions: Metabolic Syndrome

Detailed Description

This study involves a phone screen & 2 study visits:

• Screening visit, which includes a quick finger stick cholesterol, glucose, triglycerides test (cholestech) to determine qualification, waist measurement, weight. Results are provided regardless of qualification. If the volunteer qualifies, a full blood draw (approximately 45cc or 3 Tablespoons) will occur. A snack is provided once blood is drawn. Additional study visit procedures include a medical history questionnaire including menstrual history, height & weight measurement, vital signs, and waist & hip measurements. This study lasts up to 90 minutes.
• MRI visit (to occur within a week of screening visit) occurs once serum pregnancy & creatinine results are received & only if approved to continue by P.I. (e.g. negative serum pregnancy and eGFR>60). An IV catheter is placed in the antecubital vein to administer an injection of (gadolinium) contrast medium. A coil is placed on each side of the subject's neck while laying flat on a bench, with her upper body inside the MRI scanner. The entire MRI procedure takes approximately 60 minutes.

• Study Type: Observational
• Enrollment (Actual): 43

Contacts and Locations

Study Locations

• United States
  • Washington
    • Seattle, Washington, United States, 98104
      • Harborview/University of Washington

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 35 years to 50 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

• Sampling Method: Non-Probability Sample

Study Population

Pre-menopausal Women

Description

Inclusion Criteria:

• Pre-menopausal women (age 35-50)

  • still having menstrual periods

Exclusion Criteria:

• History of diabetes mellitus
• History of cardiovascular disease (peripheral vascular disease, coronary artery disease, cerebrovascular disease)
• Serum creatinine >1.2 mg/dL (eGFR <60 ml/min.)
• Active rheumatologic disease
• Use of hormonal contraception*
• Pregnant or planning a pregnancy within the next 3 months
• Fasting triglycerides ≥ 500 mg/dL
• Fasting LDL-C ≥ 190 mg/dL
• Currently taking lipid lowering medications*
• Currently taking vaso-active (blood pressure) medications*
• Hypertension: SBP ≥ 140 and or DBP ≥90 mm Hg
• Chronic use of aspirin (prn use is allowed)
• Chronic use of non-steroidal anti-inflammatory medications (prn use is allowed)
• Tobacco use within 3 months of starting study
• Participation in another clinical trial within the last 30 days

• MRI specific exclusion criteria:

  • History of claustrophobia
  • History of decrease in kidney function (eGFR <60 ml/min.)
  • History of reaction to a contrast medium or dye used for an MRI, CT Scan, or X-ray
  • History of significant anemia or other blood disease
  • History of seizures
  • MRI-incompatible metal such as internal metal hardware or devices * Drugs within the following classifications are exclusionary: Antilipemics, antilipidemics, beta blockers, ACE inhibitors, angiotensin receptor blockers, diuretics, calcium channel blockers, alpha blockers, nitrates, and all hormonal contraceptives

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Women with Metabolic Syndrome; Pre-menopausal women with Metabolic Syndrome Age 35-50 and any 3 of the following: Fasting triglycerides ≥ 150 mg/dL, Waist measurement ≥ 35 inches, HDL < 50mg/dL, Fasting glucose ≥ 100mg/dL but <126mg/dL or Blood pressure ≥ 130/85 or taking medication to treat high blood pressure.
Non-Metabolic Syndrome (healthy) women; Non-Metabolic syndrome pre-menopausal women age 35-50; Body Mass Index ≤ 25; Regular menstrual cycles (occur every 24-35 days); Fasting glucose < 100mg/dL; HDL-C ≥ 50mg/dL; Waist measurement ≤ 35 inches; Fasting triglycerides < 150mg/dL

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
ktrans of the carotid artery wall	Ktrans is a transfer constant that is a measure of vascular permeability.	baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
carotid artery intima-media thickness as measured by MRI	Carotid intima-media thickness is a measure of the actual thickness of the intima and media layers of the carotid artery wall.	baseline

Collaborators and Investigators

• Sponsor: University of Washington
• Investigators: Principal Investigator: Pathmaja Paramsothy, M.D.,M.S., University of Washington

Study record dates

Study Major Dates

• Study Start: May 1, 2009
• Primary Completion (Actual): July 1, 2012
• Study Completion (Anticipated): July 1, 2013

Study Registration Dates

• First Submitted: February 11, 2010
• First Submitted That Met QC Criteria: February 12, 2010
• First Posted (Estimate): February 15, 2010

Study Record Updates

• Last Update Posted (Estimate): September 14, 2012
• Last Update Submitted That Met QC Criteria: September 12, 2012
• Last Verified: September 1, 2012

More Information

Terms related to this study

• Keywords: metabolic syndrome; vascular risk; premenopausal women; MetS; atherosclerosis detection
• Additional Relevant MeSH Terms: Pathologic Processes; Glucose Metabolism Disorders; Metabolic Diseases; Disease; Insulin Resistance; Hyperinsulinism; Syndrome; Metabolic Syndrome
• Other Study ID Numbers: 35352-A