Denna sida har översatts automatiskt och översättningens korrekthet kan inte garanteras. Vänligen se engelsk version för en källtext.

Extracellular microRNA: Biomarkers of Endothelial Dysfunction in Obese Adolescents & Adults With Obstructive Sleep Apnea

1 juni 2018 uppdaterad av: Rakesh Bhattacharjee, University of California, San Diego

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

Using a prospective observational approach and a clinical trial design comparing the effectiveness of continuous positive airway pressure to diet and exercise, investigators plan to evaluate how obstructive sleep apnea (OSA) leads to endothelial dysfunction in adolescents and young adults and whether treatment of OSA can improve endothelial dysfunction. Concurrently, investigators will measure miR 92a/miR 210 levels in all subjects at baseline and following therapy to determine whether miR 92a/miR 210 levels reliably predict endothelial dysfunction in patients and responses to therapy.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Förväntat)

100

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

  • Namn: Rakesh Bhattacharjee, MD
  • Telefonnummer: 858-966-5846
  • E-post: rakesh@ucsd.edu

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 21 år (Vuxen)

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Allt

Beskrivning

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

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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
Enhet: Continuous Positive Airway Pressure
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.
Andra namn:
  • CPAP
Aktiv komparator: 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.
Övrig: Diet And Exercise
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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Peripheral Arterial Tonometry - Reactive Hyperemic Index
Tidsram: At baseline.
EndoPAT
At baseline.
Peripheral Arterial Tonometry - Reactive Hyperemic Index
Tidsram: At three months.
EndoPAT
At three months.
Peripheral Arterial Tonometry - Reactive Hyperemic Index
Tidsram: At six months.
EndoPAT
At six months.

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
miRNA 92a and miRNA 210 levels
Tidsram: At baseline.
Serum and Extracellular Vesicle derived miR 92a and miR 210 levels
At baseline.
miR 92a and miR 210 levels
Tidsram: At three months.
Serum and Extracellular Vesicle derived miR 92a and miR 210 levels
At three months.
miR 92a and miR 210 levels
Tidsram: At six months.
Serum and Extracellular Vesicle derived miR 92a and miR 210 levels
At six months.

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

University of California, San Diego

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Förväntat)

1 april 2019

Primärt slutförande (Förväntat)

30 juli 2024

Avslutad studie (Förväntat)

31 december 2024

Studieregistreringsdatum

Först inskickad

21 maj 2018

Först inskickad som uppfyllde QC-kriterierna

1 juni 2018

Första postat (Faktisk)

6 juni 2018

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

6 juni 2018

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

1 juni 2018

Senast verifierad

1 juni 2018

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 170408

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

JA

IPD-planbeskrivning

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.

Tidsram för IPD-delning

5 years (during the study period)

Kriterier för IPD Sharing Access

Only investigators that are listed as co-investigators with the UC San Diego Human Research Protection Program

IPD-delning som stöder informationstyp

  • STUDY_PROTOCOL
  • SAV
  • CSR

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

Prenumerera