Aldosterone and Glucose Homeostasis

NCT ID: NCT00732160

Last Updated: 2017-04-06

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

34 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-09-30

Study Completion Date

2013-12-31

Brief Summary

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Determine the effect of aldosterone on how the body handles glucose (sugar).

Detailed Description

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Determine the effect of aldosterone on glucose metabolism in humans.

Conditions

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Diabetes Mellitus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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HS-V/A; LS-V/A

High Sodium diet- Vehicle infusion then Aldosterone infusion Low Sodium diet- Vehicle infusion then Aldosterone infusion

Group Type EXPERIMENTAL

Aldosterone infusion (A)

Intervention Type DRUG

Infusion of exogenous aldosterone (0.7 mcg/kg/hr for 12.5 hrs)

Vehicle Infusion (V)

Intervention Type DRUG

Vehicle infusion for 12.5 hours

High Sodium Diet (HS)

Intervention Type OTHER

160 mmol/d sodium diet for 7 days

Low Sodium Diet (LS)

Intervention Type OTHER

20 mmol/d sodium diet for 9 days

HS-A/V; LS-A/V

High Sodium diet- Aldosterone infusion then Vehicle infusion Low Sodium diet- Aldosterone infusion then Vehicle infusion

Group Type EXPERIMENTAL

Aldosterone infusion (A)

Intervention Type DRUG

Infusion of exogenous aldosterone (0.7 mcg/kg/hr for 12.5 hrs)

Vehicle Infusion (V)

Intervention Type DRUG

Vehicle infusion for 12.5 hours

High Sodium Diet (HS)

Intervention Type OTHER

160 mmol/d sodium diet for 7 days

Low Sodium Diet (LS)

Intervention Type OTHER

20 mmol/d sodium diet for 9 days

LS-V/A; HS-V/A

Low Sodium diet- Vehicle infusion then Aldosterone infusion High Sodium diet- Vehicle infusion then Aldosterone infusion

Group Type EXPERIMENTAL

Aldosterone infusion (A)

Intervention Type DRUG

Infusion of exogenous aldosterone (0.7 mcg/kg/hr for 12.5 hrs)

Vehicle Infusion (V)

Intervention Type DRUG

Vehicle infusion for 12.5 hours

High Sodium Diet (HS)

Intervention Type OTHER

160 mmol/d sodium diet for 7 days

Low Sodium Diet (LS)

Intervention Type OTHER

20 mmol/d sodium diet for 9 days

LS-A/V; HS-A/V

Low Sodium diet- Aldosterone infusion then Vehicle infusion High Sodium diet- Aldosterone infusion then Vehicle infusion

Group Type EXPERIMENTAL

Aldosterone infusion (A)

Intervention Type DRUG

Infusion of exogenous aldosterone (0.7 mcg/kg/hr for 12.5 hrs)

Vehicle Infusion (V)

Intervention Type DRUG

Vehicle infusion for 12.5 hours

High Sodium Diet (HS)

Intervention Type OTHER

160 mmol/d sodium diet for 7 days

Low Sodium Diet (LS)

Intervention Type OTHER

20 mmol/d sodium diet for 9 days

Interventions

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Aldosterone infusion (A)

Infusion of exogenous aldosterone (0.7 mcg/kg/hr for 12.5 hrs)

Intervention Type DRUG

Vehicle Infusion (V)

Vehicle infusion for 12.5 hours

Intervention Type DRUG

High Sodium Diet (HS)

160 mmol/d sodium diet for 7 days

Intervention Type OTHER

Low Sodium Diet (LS)

20 mmol/d sodium diet for 9 days

Intervention Type OTHER

Other Intervention Names

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placebo

Eligibility Criteria

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Inclusion Criteria

1. Ambulatory subjects, 18 to 70 years of age, inclusive
2. For female subjects, the following conditions must be met:

a postmenopausal status for at least 1 year, or b status-post surgical sterilization, or c if of childbearing potential, utilization of adequate birth control and willingness to undergo urine beta-hcg testing prior to drug treatment and on every study day
3. Metabolic Syndrome as defined by the presence of \> 3 of the following:

a Systolic Blood Pressure \> 130 mm Hg OR Diastolic Blood Pressure \> 85 mm Hg. b Glucose Intolerance (Fasting Plasma Glucose \> 100 mg/dL) c Increased triglyceride level \> 150mg/dL (1.7mmol/L) d Decreased levels of HDL cholesterol For males, less than 40 mg/dL For females, less than 50 mg/dL e Waist circumference For males, greater than 40 inches (102 cm) For females, greater than 35 inches (89 cm).

Exclusion Criteria

1. Previously diagnosed Type I Diabetes , or the use of anti-diabetic medication. Subjects with type II diabetes not on medication will be allowed to participate if fasting blood glucose is \<200mg/dL.
2. Prior allergies to medications used in the study protocol (e.g. L-arginine, potassium chloride).
3. Screening plasma potassium \<3.5 mmol/L or use of chronic potassium supplements for the treatment of hypokalemia
4. Use of hormone replacement therapy
5. If on statin therapy for hypercholesterolemia, a change in dose within the past 6 months.
6. Breast-feeding
7. Cardiovascular disease such as prior myocardial infarction, presence of angina pectoris, significant arrhythmia, congestive heart failure (LV hypertrophy acceptable), deep vein thrombosis, pulmonary embolism, second or third degree heart block, mitral valve stenosis, aortic stenosis or hypertrophic cardiomyopathy
8. Treatment with anticoagulants
9. History of serious neurologic disease such as cerebral hemorrhage, stroke, seizure, or transient ischemic attack
10. History or presence of immunological or hematological disorders
11. Diagnosis of asthma requiring use of inhaled beta agonist \>1 time per week
12. Clinically significant gastrointestinal impairment that could interfere with drug absorption
13. Impaired hepatic function \[aspartate amino transaminase (AST) and/or alanine amino transaminase (ALT) \>2.0 x upper limit of normal range\]
14. Impaired renal function \[estimated glomerular filtration rate (eGFR) of \<60ml/min\] as determined by the four-variable Modification of Diet in Renal Disease (MDRD) equation, where serum creatinine (Scr) is expressed in mg/dl and age in years:
15. eGFR \<60 ml/min
16. Hematocrit \<35%
17. Any underlying or acute disease requiring regular medication which could possibly pose a threat to the subject or make implementation of the protocol or interpretation of the study results difficult, such as arthritis treated with non-steroidal antiinflammatory drugs
18. Treatment with chronic systemic glucocorticoid therapy (more than 7 consecutive days in 1 month)
19. Treatment with lithium salts
20. History of alcohol or drug abuse
21. Treatment with any investigational drug in the 1 month preceding the study
22. Mental conditions rendering the subject unable to understand the nature, scope and possible consequences of the study
23. Inability to comply with the protocol, e.g., uncooperative attitude, inability to return for follow-up visits, and unlikelihood of completing the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

Vanderbilt University

OTHER

Sponsor Role lead

Responsible Party

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James Matt Luther

Assistant Professor of Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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James M Luther, MD

Role: PRINCIPAL_INVESTIGATOR

Vanderbilt University Medical Center

Locations

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Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

Countries

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United States

References

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Ramirez CE, Shuey MM, Milne GL, Gilbert K, Hui N, Yu C, Luther JM, Brown NJ. Arg287Gln variant of EPHX2 and epoxyeicosatrienoic acids are associated with insulin sensitivity in humans. Prostaglandins Other Lipid Mediat. 2014 Oct;113-115:38-44. doi: 10.1016/j.prostaglandins.2014.08.001. Epub 2014 Aug 28.

Reference Type DERIVED
PMID: 25173047 (View on PubMed)

Luther JM, Byrne LM, Yu C, Wang TJ, Brown NJ. Dietary sodium restriction decreases insulin secretion without affecting insulin sensitivity in humans. J Clin Endocrinol Metab. 2014 Oct;99(10):E1895-902. doi: 10.1210/jc.2014-2122. Epub 2014 Jul 16.

Reference Type DERIVED
PMID: 25029426 (View on PubMed)

Brown JM, Williams JS, Luther JM, Garg R, Garza AE, Pojoga LH, Ruan DT, Williams GH, Adler GK, Vaidya A. Human interventions to characterize novel relationships between the renin-angiotensin-aldosterone system and parathyroid hormone. Hypertension. 2014 Feb;63(2):273-80. doi: 10.1161/HYPERTENSIONAHA.113.01910. Epub 2013 Nov 4.

Reference Type DERIVED
PMID: 24191286 (View on PubMed)

Other Identifiers

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080248

Identifier Type: -

Identifier Source: org_study_id

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