Tyypin 2 diabetes ja veri-aivoesteen parantaminen
keskiviikko 11. maaliskuuta 2026 päivittänyt: Rajesh Kumar, PhD, University of California, Los Angeles
Tyypin 2 diabetes mellitus ja veri-aivoesteen parantaminen – satunnaistettu kliininen tutkimus
Suurin osa T2DM-aikuisista kärsii tiamiinin (B1-vitamiinin) puutteesta, mikä voi vaikuttaa toiminnan heikkenemiseen.
Tässä tutkimuksessa tutkitaan T2DM-potilaita aivojen MRI-skannauksilla, kognitioarvioinneilla, verikokeilla ja kyselyillä.
Tavoitteenamme on nähdä, voiko tiamiinihoito (B1-vitamiinikapseleiden ottaminen) parantaa toimintaa.
Potilaita pyydetään tulemaan UCLA:han kaksi kertaa kolmen kuukauden välein ja jokainen käynti kestää noin 2,5-3 tuntia.
Tutkimuksen yleiskatsaus
Yksityiskohtainen kuvaus
Tyypin 2 diabetes mellitus (T2DM) muodostaa 90–95 % kaikista diagnosoiduista diabeteksesta, ja se on vakava terveysongelma Yhdysvalloissa.1 T2DM-aikuisilla on merkittäviä mieliala- ja kognitiivisia puutteita, oireita, jotka liittyvät korkeampaan sairastuvuuteen ja kuolleisuuteen, huono itsehoito ja heikentynyt elämänlaatu, ja tila liittyy varhaiseen dementiaan ja Alzheimerin tautiin. Aivojen rakenteellisia muutoksia ilmenee T2DM-aikuisilla paikoissa, joilla on suuri vaikutus kognitio- ja mielialatoimintoihin, mikä saattaa johtua heikentyneestä veri-aivoestetoiminnasta (BBB). On kuitenkin epäselvää, voidaanko BBB-toimintoa korjata T2DM-aikuisilla, mikä vähentää heikentynyttä kognitio- ja mielialatoimintoja sekä dementian ja Alzheimerin taudin varhaisia riskejä.
Useat esikliiniset tutkimukset ehdottavat mahdollisuutta BBB-toiminnan korjaamiseen, mukaan lukien edullinen tiamiiniinterventio. Tiamiini on välttämätön hiilihydraattiaineenvaihdunnan yhteistekijä, ja riittävät tai korkeammat tasot edistävät aerobista aineenvaihduntaa ja vähentävät hermovaurioita. Lisäksi alentuneiden tiamiinitasojen on osoitettu vaikuttavan endoteelisolujen toiminnan heikkenemiseen, ja suuremmat tiamiiniannokset parantavat endoteelitoimintoja. Siten alhaisemmat tiamiinitasot voivat edistää hermosolujen ja endoteelisolujen toimintahäiriöitä, mikä johtaa heikentyneeseen BBB-toimintaan. Suurimmalla osalla T2DM-aikuisista on tiamiinin puutos, mikä voi vaikuttaa heikentyneeseen BBB-toimintaan, mutta on epäselvää, voiko tiamiinihoito parantaa BBB-toimintaa T2DM-aikuisilla. Tutkijat olettavat, että tiamiiniinterventio (3 kuukautta) vähentää heikentynyttä BBB-toimintaa ja parantaa kognitio- ja mielialatoimintoja tiamiinihoitoa saavilla T2DM-aikuisilla verrattuna hoitamattomiin T2DM-aikuisiin.
Yhteenvetona voidaan todeta, että tutkijat ehdottavat, että edullinen 3 kuukauden tiamiinihoito T2DM-aikuisilla korjaa BBB-häiriöitä ja parantaa mielialaa ja kognitiotoimintoja. Jos tutkimukset onnistuvat, tämän kliinisen tutkimuksen tulokset voivat toimia uudenlaisena ja innovatiivisena hoitostrategiana BBB-toiminnan korjaamiseksi, mikä vaikuttaa vähemmän kognitio- ja mielialatoimintoihin ja siten parempiin tuloksiin T2DM-aikuisilla sekä muissa aikuisten sairauksissa, joissa BBB-toiminta on heikentynyt. . Tämä R21-kartollinen kliininen koetutkimus tarjoaa tarvittavat tiedot edullisista tiamiiniinterventioista, joita voitaisiin toteuttaa laajamittaisessa kliinisessä tutkimuksessa BBB-toiminnan korjaamiseksi T2DM-aikuisilla, mikä vastaa National Institutes of Healthin tehtävää, ja näin ollen vähentää dementian ja Alzheimerin taudin varhaisia riskejä, vähentää sairastuvuutta ja kuolleisuutta ja parantaa elämänlaatua tässä vakavassa ja yleisessä T2DM-potilaspopulaatiossa.
Opintotyyppi
Interventio
Ilmoittautuminen (Arvioitu)
52
Vaihe
- Varhainen vaihe 1
Yhteystiedot ja paikat
Tässä osiossa on tutkimuksen suorittajien yhteystiedot ja tiedot siitä, missä tämä tutkimus suoritetaan.
Opiskeluyhteys
- Nimi: Rajesh Kumar, PhD
- Puhelinnumero: 310-206-1699
- Sähköposti: rkumar@mednet.ucla.edu
Tutki yhteystietojen varmuuskopiointi
- Nimi: Dineth R Karunamuni, MS
- Puhelinnumero: 856-701-5332
- Sähköposti: dkarunamuni@mednet.ucla.edu
Opiskelupaikat
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California
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Los Angeles, California, Yhdysvallat, 90095
- Rekrytointi
- UCLA
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Ottaa yhteyttä:
- Rajesh Kumar, PHD
- Puhelinnumero: 310-825-1808
- Sähköposti: rkumar@mednet.ucla.edu
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Päätutkija:
- Rajesh Kumar, PHD
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Ottaa yhteyttä:
- Dineth R Karunamuni, MS
- Puhelinnumero: 856-701-5332
- Sähköposti: dkarunamuni@mednet.ucla.edu
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Osallistumiskriteerit
Tutkijat etsivät ihmisiä, jotka sopivat tiettyyn kuvaukseen, jota kutsutaan kelpoisuuskriteereiksi. Joitakin esimerkkejä näistä kriteereistä ovat henkilön yleinen terveydentila tai aiemmat hoidot.
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Ei
Kuvaus
Sisällyttämiskriteerit:
- Diagnosoitu T2DM
- Avohoitotila
- Voidaan asettaa tasaiseksi kuvantamista varten
Poissulkemiskriteerit:
- Aikaisempi aivohalvauksen historia
- Nykyinen tiamiinin saanti
- Tunnettu tiamiiniallergia
- Kouristuksellinen sairaus
- Päävamma
- Sydäninfarkti
- Nykyinen raskaus (jos nainen)
- Diagnosoidut neuropsykiatriset häiriöt (kliininen masennus, skitsofrenia, maaninen masennus)
- Diagnosoitu dementia
- Unihäiriöinen hengitys
- Hengitysteiden tai rintakehän epämuodostumat, jotka häiritsevät hengitystä
- Krooninen keuhkoahtaumatauti
- Kystinen fibroosi
- Aivomassavaurioiden esiintyminen
- Mikä tahansa historia huumeiden väärinkäytöstä (esim. kokaiini, tupakka tai kannabis)
- Munuaisten vajaatoiminta (vaatii dialyysin)
- Kaikki T2DM-aikuiset, joilla on metalliset ja elektroniset implantit (freniset tai sydämentahdistimet; vaikka jotkut sydämentahdistimet ja kardiovertteridefibrillaattorit ovat turvallisia alhaisella magneettikentällä, ne eivät ole turvallisia 3.0-Tesla-skannerilla)
- Ei irrotettava insuliinipumppu/glukoosianturi
- Aaltosulkeet
- Ruumiinpaino yli 300 puntaa (painoa ja pituutta käytetään BMI:n laskemiseen sen määrittämiseksi, mahtuuko potilas skanneriin ja pysyykö MRI-skanneritaulukon kokorajoitusten parametrien sisällä)
- Myös kaikki muut magneettikuvauksen vasta-aiheet, kuten klaustrofobia tai metallipohjaiset tatuoinnit, magneettikuvauksen turvallisuussivuston suositusten mukaisesti suljetaan pois.
Opintosuunnitelma
Tässä osiossa on tietoja tutkimussuunnitelmasta, mukaan lukien kuinka tutkimus on suunniteltu ja mitä tutkimuksella mitataan.
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Ennaltaehkäisy
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Yksittäinen
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
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Kokeellinen: BBB-toiminta, kognitio ja mieliala T2DM-aikuisilla tiamiinihoidolla.
Analysoi BBB-toimintaa, kognitiokykyä ja mielialaa T2DM-aikuisten tiamiinihoitoa saaneilla ja vertaa lumeryhmään.
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Osallistujia opastetaan ottamaan yksi 500 mg:n tiamiinikapseli (B1-vitamiini) joka päivä aamulla 3 kuukauden ajan.
Muut nimet:
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Placebo Comparator: BBB-toiminta, kognitio ja mieliala T2DM-aikuisilla ilman tiamiinihoitoa.
Analysoi BBB-toimintaa, kognitiota ja mielialaa T2DM-aikuisilla ilman tiamiinihoitoa ja vertaa tiamiinihoitoryhmään.
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Osallistujia opastetaan ottamaan yksi kapseli (plasebo) joka päivä aamulla 3 kuukauden ajan.
Muut nimet:
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
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Arvioi, onko BBB-toiminto korjattu.
Aikaikkuna: 3 kuukauden kuluttua
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Arvioi veriaivoesteen toiminta.
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3 kuukauden kuluttua
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Analysoi veren seerumin S100β-tasot.
Aikaikkuna: 3 kuukauden kuluttua
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Analysoi veren seerumin S100β (BBB:n eheyden merkki) tasot nähdäksesi, ovatko ne alentuneet tiamiinilla hoidetuilla T2DM-aikuisilla verrattuna T2DM-aikuisiin ilman tiamiinihoitoa.
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3 kuukauden kuluttua
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Tutki kognitiokykyä T2DM-aikuisilla tiamiinihoidolla.
Aikaikkuna: 3 kuukauden kuluttua
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Tutkija tutkii kognitiota käyttämällä Wide Range Assessment of Memory and Learning 2:ta (WRAML2) nähdäkseen, onko tiamiinihoitoa saavilla T2DM-aikuisilla parantunut kognitio verrattuna T2DM-aikuisiin, jotka eivät saa tiamiinihoitoa.
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3 kuukauden kuluttua
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Kognition arviointi T2DM-aikuisilla tiamiinihoidon jälkeen.
Aikaikkuna: 3 kuukauden kuluttua
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Tutkija arvioi kognition käyttämällä Montrealin kognitiivista arviointia (MoCA) nähdäkseen, osoittavatko tiamiinihoitoa saaneet T2DM-aikuiset parempaa kognitiota kuin T2DM-aikuiset, jotka eivät saa tiamiinihoitoa.
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3 kuukauden kuluttua
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Tutki masennusta T2DM-aikuisilla tiamiinihoidolla.
Aikaikkuna: 3 kuukauden kuluttua
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Tutkija tutkii masennusta käyttämällä Beck Depression Inventory II:ta (BDI-II) nähdäkseen, onko tiamiinihoitoa saavilla T2DM-aikuisilla parantunut mieliala verrattuna T2DM-aikuisiin, jotka eivät saa tiamiinihoitoa.
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3 kuukauden kuluttua
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Arvioi T2DM-aikuisten ahdistuneisuus tiamiinihoidolla.
Aikaikkuna: 3 kuukauden kuluttua
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Tutkija arvioi ahdistusta käyttämällä Beck Anxiety Inventory (BAI) -tutkimusta nähdäkseen, onko tiamiinihoitoa saaneiden T2DM-aikuisten mieliala parantunut verrattuna T2DM-aikuisiin, jotka eivät saa tiamiinihoitoa.
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3 kuukauden kuluttua
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Yhteistyökumppanit ja tutkijat
Täältä löydät tähän tutkimukseen osallistuvat ihmiset ja organisaatiot.
Yhteistyökumppanit
Julkaisuja ja hyödyllisiä linkkejä
Tutkimusta koskevien tietojen syöttämisestä vastaava henkilö toimittaa nämä julkaisut vapaaehtoisesti. Nämä voivat koskea mitä tahansa tutkimukseen liittyvää.
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Tähän tutkimukseen liittyvät termit
Avainsanat
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
- 23-001083
- 1R21AG085268-01 (Yhdysvaltain NIH-apuraha/sopimus)
Yksittäisten osallistujien tietojen suunnitelma (IPD)
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JOO
IPD-suunnitelman kuvaus
Tutkija tekee kaikkensa julkaistakseen tiedot ajoissa.
Kun veri-aivoesteen muutoksiin liittyvät löydökset, jotka perustuvat aivojen MRI-tietoihin ennen ja jälkeen tiamiiniinterventiota, on julkaistu tai palkintojakson loppuun mennessä, sen mukaan, kumpi on aikaisemmin, MRI-tiedot, demografiset tiedot, mieliala ja kognitio sekä kliiniset tiedot ( ilman yksittäisiä tunnisteita) tallennetaan NIH:n tukemaan verkkotunnuskohtaiseen tiedonjakovarastoon (NIMH Data Archive).
Kaikki tiedot merkitään yhtenäisillä yksilöllisillä tunnisteilla, jotka tekevät siitä kiinnostuneiden tutkijoiden helposti löydettävissä tietovarastosta.
Tiedot ovat ikuisesti käytettävissä sen jälkeen, kun ne on jaettu tietovaraston kanssa muille tutkijoille toissijaisia analyyseja varten.
IPD-jaon aikakehys
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IPD-jaon käyttöoikeuskriteerit
Kuka tahansa tutkija
IPD-jakamista tukeva tietotyyppi
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Lääke- ja laitetiedot, tutkimusasiakirjat
Tutkii yhdysvaltalaista FDA sääntelemää lääkevalmistetta
Ei
Tutkii yhdysvaltalaista FDA sääntelemää laitetuotetta
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Yhdysvalloissa valmistettu ja sieltä viety tuote
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