Extracellular microRNA: Biomarkers of Endothelial Dysfunction in Obese Adolescents & Adults With Obstructive Sleep Apnea
Extracellular Micro RNA (miR) (Extracellular Vesicle (EV)-Associated & Non-EV-associated miRs) Identify and Mediate Endothelial Dysfunction in Obesity and Obstructive Sleep Apnea in Adolescents & Young Adults
調査の概要
詳細な説明
Investigators will randomize 100 OSA patients (age 13-21) to receive either continuous positive airway pressure (CPAP) plus baseline diet/exercise (n=50) or medical management (intensive diet and exercise; n=50). Only children in whom adenotonsillectomy is contraindicated (morbid obesity, history of adenotonsillectomy, lack of adenotonsillar hypertrophy) will be included. Investigators will conduct a randomized prospective comparative effectiveness study to assess the impact of treatment on OSA on endothelial function (peripheral arterial tonometry-EndoPAT). In addition to diagnostic polysomnography and EndoPAT at baseline, EV (extracellular vesicle) and non EV derived miR 92a/miR 210 concentrations, inflammatory cytokines concentrations, and body anthropometry will be measured. Following 3 mos of therapy and after 6mos of therapy, investigators will re-evaluate EndoPAT, EV and non EV derived miR 92a/miR 210 concentrations, inflammatory cytokines, and body anthropometry.
Throughout the study, investigators will maintain weekly telephone contact and monthly face-to-face visits as per standard of care in both groups to ensure ongoing success. In the medical management group (intensive diet and exercise), diet and exercise will be tracked by maintaining weekly telephone contact and monthly face-to-face visits with a registered dietician. For the CPAP group, investigators will also maintain weekly telephone contact and monthly face-to-face visits with a sleep technician to review mask fitting, and adherence reports, to optimize adherence to CPAP therapy.
Following completion at six months, polysomnography will be repeated.
研究の種類
入学 (予想される)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前：Rakesh Bhattacharjee, MD
- 電話番号：858-966-5846
- メール：rakesh@ucsd.edu
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Otherwise healthy children and young adults with a diagnosis of obstructive sleep apnea based on polysomnography criteria of an obstructive apnea hypopnea index > 10 events/hr.
- For children a BMI range up to 99.7% and for adults BMI up to 32 kg/m2 is used.
Exclusion Criteria:
- The presence of elevated blood pressure
- The presence of diabetes or pre-diabetes
- The presence of craniofacial anomalies
- The presence of neuromuscular disorders
- The presence of syndromic or defined genetic abnormalities
- Pregnancy
- History of smoking (any smoking within the prior 6 mos or >5 pack years total)
- The presence of infectious disease (e.g. including hepatitis B, C, HIV etc.)
- The presence of collagen vascular disease (e.g. lupus, arthritis, scleroderma, polymyositis, mixed-connective tissue disease, vasculitis etc)
- The presence of hepatic disease (including hepatitis fatty liver or cirrhosis)
- The presence of renal disease (including azotemia or clinical proteinuria)
- The presence of cardiopulmonary disease (e.g. known asthma, cystic fibrosis, congenital heart disease)
- Individuals using medications which could affect sleep or breathing (including hypnotics)
- Individuals using chronic anti-inflammatory therapy
- Individuals with any subjects with acute or chronic illness.
- Individuals using anti-hypertensive therapies
- Children with a a BMI > 99.7%
- Adults with a BMI > 32 kg/m2
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的：CPAP
This arm will consist of patients with obstructive sleep apnea who will be asked to use CPAP nightly to treat their OSA for six months
|
This device delivers air pressure non invasively through a mask to stent open the upper airway to prevent obstruction during sleep.
This is an FDA approved device that has been used for several decades to treat OSA.
他の名前：
|
|
アクティブコンパレータ：Diet and Exercise
This arm will consist of patients with obstructive sleep apnea who will be asked to engage in dietary management and regular exercise for six months.
|
This will consist of weekly telephone and monthly face to face visits to monitor and suggest measures to improve diet and regular exercise as conducted by a registered dietician.
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Peripheral Arterial Tonometry - Reactive Hyperemic Index
時間枠：At baseline.
|
EndoPAT
|
At baseline.
|
|
Peripheral Arterial Tonometry - Reactive Hyperemic Index
時間枠：At three months.
|
EndoPAT
|
At three months.
|
|
Peripheral Arterial Tonometry - Reactive Hyperemic Index
時間枠：At six months.
|
EndoPAT
|
At six months.
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
miRNA 92a and miRNA 210 levels
時間枠：At baseline.
|
Serum and Extracellular Vesicle derived miR 92a and miR 210 levels
|
At baseline.
|
|
miR 92a and miR 210 levels
時間枠：At three months.
|
Serum and Extracellular Vesicle derived miR 92a and miR 210 levels
|
At three months.
|
|
miR 92a and miR 210 levels
時間枠：At six months.
|
Serum and Extracellular Vesicle derived miR 92a and miR 210 levels
|
At six months.
|
協力者と研究者
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始 (予想される)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- 170408
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
Intellectual property and data generated under this project will be administered in accordance with both University and NIH policies, including the NIH Data Sharing Policy and Implementation Guidance of March 5, 2003.
As a part of this application will involve human subjects, investigators believe that the rights and privacy of people who will participate in the research project must be protected at all times. In case other investigators express interest in working with the data, every effort will be made to provide the data to them free of identifiers. However, such endeavors will have to be individually considered and also approved by the University of California (UC) San Diego Human Research Protection Program before any commitments can be made.
IPD 共有時間枠
IPD 共有アクセス基準
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
- SAP
- CSR
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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