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Vigabatrin and Insulin Sensitivity

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登陸註冊
鏈接已保存到剪貼板
狀態尚未招聘
贊助商
Washington University School of Medicine

關鍵詞

抽象

Nonalcoholic fatty liver disease (NAFLD) is a common complication of obesity and is associated with an increased risk of developing type 2 diabetes. The hallmark feature of NAFLD is an increase in intrahepatic triglyceride (IHTG) content. Data from studies conducted in rodent models suggest increased IHTG content can alter hepatic vagal afferent nerve (HVAN) activity. In rodent models of obesity and NAFLD, HVAN activity is reduced leading to impaired insulin sensitivity and glucose control. The reduction in HVAN activity is likely due to increased hepatic release of GABA, an inhibitory neurotransmitter, attributable to increased expression of GABA-Transaminase (GABA-T). Pharmacological inhibition of GABA-T in obese mice by treatment with vigabatrin, an irreversible inhibitor of GABA-T improves glucose tolerance and reduces hyperinsulinemia, hyperglycemia, and insulin resistance. It is not known if vigabatrin can also improve metabolic function in people. We propose to conduct a randomized clinical controlled trial to determine the effect of vigabatrin on insulin sensitivity and oral glucose tolerance in adults with obesity and NAFLD.

日期

最後驗證: 02/29/2020
首次提交: 03/22/2020
提交的預估入學人數: 03/22/2020
首次發布: 03/24/2020
上次提交的更新: 03/22/2020
最近更新發布: 03/24/2020
實際學習開始日期: 05/31/2020
預計主要完成日期: 05/31/2022
預計完成日期: 05/31/2023

狀況或疾病

NAFLD
Obesity

干預/治療

Drug: Vigabatrin

Drug: Placebo

相 2

手臂組

干預/治療
Experimental: Vigabatrin
Drug: Vigabatrin
Vigabatrin - Pill, 500 mg twice daily for 7 days (days 0-6), 1000 mg twice daily for 7 days (days 7-13), 1500 mg twice daily for 10 days (days 14-23), 1000 mg twice daily for 7 days (days 24-30), 500 mg twice daily for 7 days (days 31-37) and will discontinue treatment on day 38.
Placebo Comparator: Placebo
Drug: Placebo
Pill, 1 pill twice daily for 7 days (days 0-6), 2 pills twice daily for 7 days (days 7-13), 3 pills twice daily for 10 days (days 14-23), 2 pills twice daily for 7 days (days 24-30), 1 pill twice daily for 7 days (days 31-37) and will discontinue on day 38.

資格標準

有資格學習的年齡 18 Years 至 18 Years
有資格學習的性別All
接受健康志願者
標準

Inclusion Criteria:

- age 25-60 years old

- BMI 30.0-49.9 kg/m2

- IHTG content ≥5.6

- Homeostatic Model of Insulin Resistance (HOMA-IR) Score>2.5.

Exclusion Criteria:

- i) medical, surgical, or biological menopause; ii) previous bariatric surgery; iii) structured exercise ≥250 min per week (e.g., brisk walking); iv) unstable weight (>4% change during the last 2 months before entering the study); v) significant organ system dysfunction (e.g., diabetes, severe pulmonary, kidney or cardiovascular disease); vi) cancer; vii) polycystic ovary syndrome; viii) major psychiatric illness; ix) conditions that render subject unable to complete all testing procedures (e.g., severe ambulatory impairments, limb amputations, or metal implants that interfere with imaging procedures; coagulation disorders); x) regular use of tobacco products; xi) excessive consumption of alcohol (≥3 drinks/day for men and ≥2 drinks/day for women); xii) use of medications that are known to affect the study outcome measures or increase the risk of study procedures and that cannot be temporarily discontinued for this study; xiii) pre-exisiting visual field deficits; xiv) pregnant or lactating women; xv) conditions that render subject unable to complete all testing procedures (e.g. aversion to needles, metal implants that prevent magnetic resonance imaging); xvi) persons who are unable or unwilling to follow the study protocol; and xvii) persons who are not able to grant voluntary informed consent

結果

主要結果指標

1. Insulin Sensitivity [3 weeks after initiation of treatment]

Measured by hyperglycemic euglycemic clamp

次要成果指標

1. Oral Glucose Tolerance [3 weeks after initiation of treatment]

Measured by 75 gram oral glucose tolerance test

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