- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02326129
Novel Biomarker for Development of T2D
A Novel Biomarker for Development of Type 2 Diabetes: 11Beta-Hydroxy Steroid Dehydrogenase Type 1 Activity
Study Overview
Status
Conditions
Detailed Description
The overarching hypothesis is that increases in whole body 11β-HSD1 activity precede and presage the development of type 2 diabetes (T2D) in high-risk obese adolescents, serving as a critical determinant of insulin resistance and glucose intolerance. The increase in 11β-HSD1 activity, in combination with decreases in 5α-reductase activity, will increase tissue cortisol production, promoting the development of insulin resistance and the metabolic syndrome and predisposing to T2D. The investigators predict that increases in 11β-HSD1 activity will be detected in obese children prior to the development of insulin resistance and glucose intolerance and that the progressive increases in 11β-HSD1 will correlate with progressive decreases in insulin sensitivity and glucose tolerance. Given preliminary findings, the investigators also predict that increases in 11β-HSD1 will be greater and occur earlier in development in males than females. This could establish 11β-HSD1 activity as a novel, non-invasive biomarker for progression to, or for development of, glucose intolerance and T2D.
The identification of 11β-HSD1 as a biomarker that predicts T2D would have critical clinical import, allowing us to identify obese children and adults at highest risk of metabolic decompensation. Studies of 11β-HSD1 in obese subjects with varying degrees of IR and glucose intolerance will also narrow critical gaps in the understanding of the pathogenesis of T2D.
The investigators would like to also validate if urine metabolomic profiling can be used for identifying key metabolomic signatures associated with insulin resistance. To that end the investigators would like to examine detailed metabolomic profiles in 24 hour and spot urine samples.
The study population will include 50 obese adolescents with T2D, 50 obese adolescents without T2D and 50 age, gender, race and pubertal status-matched normal weight controls. The subjects will be recruited at the Healthy Lifestyle Program at Duke, Diabetes Clinics at Lenox Baker Children's Hospital and Roxboro Clinics.
Study activities include physical exam and medical history, vitals, laboratory tests (only for obese adolescents), urine testing for sugar (only for normal weight adolescents), 24 hour urine collection, spot urine collection, body fat content measurement, and food and activity questionnaire.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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Louisiana
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Baton Rouge, Louisiana, United States, 70803
- Pennington Biomedical Research Center
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North Carolina
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Chapel Hill, North Carolina, United States, 27514
- UNC Chapel Hill
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Durham, North Carolina, United States, 27710
- Duke University
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion criteria:
- Obese/Overweight adolescents/young adults without T2D who are having their first visit to the Healthy Lifestyle Program at Duke or Obese/Overweight adolescents/young adults without T2D recruited from the community at PBRC
- Obese/Overweight adolescents/young adults with prediabetes (HbA1c between 5.7-6.4%) and T2D (HbA1c≥6.5%)followed at Diabetes Clinics or recruited from the community at PBRC
- Age, gender, race and pubertal status matched normal weight adolescents presenting for "well child check" at Roxboro Clinics
- ≥12 to 21 (inclusive) years of age for urine studies
- 18-21 years of age obese adolescents/young adults without T2D and age, gender, race and pubertal status matched normal weight controls for OGTT sub-study
- Both the subject and one parent/guardian present will need to be able to speak and read English
Exclusion criteria:
- Currently or within the past month taken systemic or inhaled corticosteroids, antipsychotics, medications for weight loss, topiramate, acute use of contraceptives (less than 3 months) or medroxy-progesterone acetate, medications to treat ADHD
- Children with any genetic syndrome
- Children with decompensated hypothyroidism (treated with levothyroxine and a TSH >10 µIU/mL )
- Normal weight children (BMI percentile 5%-<85%) with glucosuria, as defined by a positive urine glucose dip stick test
- Children and young adults who self report that they are pregnant (pregnancy is excluded in both the main and sub-study)
- Proteinuria, as defined by protein level equal to or above 300 mg/dl (+++) on a urine dip stick test.
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Control
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
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Obese with Type 2 Diabetes
Obese adolescents with Type 2 Diabetes
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Obese without Type 2 Diabetes
Obese adolescents without Type 2 Diabetes
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Normal weight
Normal weight adolescents
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Relationship between 11β-HSD1 and 5α-reductase activity, and measures of insulin resistance
Time Frame: One year
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To assess the relationship between 11β-HSD1 and 5α-reductase activity, and measures of insulin resistance in a cohort of obese children with varying degrees of insulin resistance and glucose intolerance
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One year
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Gender and pubertal status
Time Frame: One year
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Investigate the role of gender and pubertal status on 11β-HSD1 and 5α-reductase activity
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One year
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Compare 11β-HSD1 activity and 5α-reductase activity among obese adolescents with T2D, obese adolescents without T2D and normal weight controls
Time Frame: One year
|
The investigators hypothesize that obese adolescents with T2D will have the highest levels of 11β-HSD1 activity followed by the obese adolescents with insulin resistance, followed by obese subjects with normal insulin sensitivity.
Normal weight control group will have the lowest levels.
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One year
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Relationship between 11β-HSD1 and 5α-reductase activity, and key metabolic signatures associated with insulin resistance
Time Frame: One year
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The investigators hypothesize that 11β-HSD1 activity will be positively associated, and 5α-reductase activity negatively associated, with key metabolic signatures associated with insulin resistance.
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One year
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Urine metabolic signatures associated with insulin resistance and type 2 diabetes
Time Frame: One year
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The investigators would like to validate if urine metabolomic profiling can be used for identifying key metabolomic signatures associated with insulin resistance
|
One year
|
Spot urine for metabolic profiling
Time Frame: One year
|
The investigators hypothesize that they will identify the same key metabolomic signatures associated with insulin resistance in obese adolescents with T2D compared to obese adolescents without T2D, and normal weight control group in spot fasting am urine samples.
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One year
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Metabolic signatures correlate with parameters of glucose tolerance
Time Frame: One year
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To determine if urinary metabolic signatures correlate with parameters of glucose tolerance in normal weight controls and obese adolescents without T2D, and glycemic control in obese subjects with T2D.
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One year
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Pinar Gumus Balikcioglu, M.D., Pediatric Endocrinology
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Pro00057460
- K23DK117067 (U.S. NIH Grant/Contract)
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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