RYGB and the Gastric Adipose Axis

NCT ID: NCT01474785

Last Updated: 2018-05-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

49 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-01-31

Study Completion Date

2015-07-31

Brief Summary

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The purpose of this study is to determine if interruption in gastric-adipose tissue axis signaling contributes to early improvements in oxidative stress, insulin sensitivity, and inflammation, and to determine if interruption of the stomach in RYGB results in reduction of plasma acylated ghrelin (AG) and in an altered acylated ghrelin:unacylated ghrelin (AG:UAG) ratio which may contribute to decreased oxidative stress and improved insulin sensitivity.

Detailed Description

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Conditions

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Obesity

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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RYGB

Roux-en-Y gastric bypass surgery (RYGB) subjects to undergo hyperinsulinemic-euglycemic clamp with human ghrelin infusion pre-operatively and post-operatively.

Group Type EXPERIMENTAL

human ghrelin

Intervention Type DRUG

0.5-1 pmol/kg.min of human ghrelin administered by IV two times

Hyperinsulinemic/Euglycemic Clamp

Intervention Type PROCEDURE

Insulin and glucose infusions to measure glucose kinetics.

VSG

Vertical sleeve gastrectomy (VSG) subjects to undergo hyperinsulinemic-euglycemic clamp pre-operatively and post-operatively.

Group Type EXPERIMENTAL

Hyperinsulinemic/Euglycemic Clamp

Intervention Type PROCEDURE

Insulin and glucose infusions to measure glucose kinetics.

Low Calorie Diet

Subjects will receive very low calorie diet prescribed for RYGB patients and undergo hyperinsulinemic-euglycemic before and after diet.

Group Type EXPERIMENTAL

very low calorie diet

Intervention Type OTHER

standard very low calorie diet that is prescribed for all RYGB patients after their operation

Hyperinsulinemic/Euglycemic Clamp

Intervention Type PROCEDURE

Insulin and glucose infusions to measure glucose kinetics.

Interventions

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human ghrelin

0.5-1 pmol/kg.min of human ghrelin administered by IV two times

Intervention Type DRUG

very low calorie diet

standard very low calorie diet that is prescribed for all RYGB patients after their operation

Intervention Type OTHER

Hyperinsulinemic/Euglycemic Clamp

Insulin and glucose infusions to measure glucose kinetics.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age 18-65 years
* BMI ≥ 35 kg/m\^2
* Scheduled for bariatric surgery
* Considering bariatric surgery
* Waiting for insurance approval for bariatric surgery
* Currently not considering bariatric surgery, but otherwise eligible
* Enrollment in medical weight loss program

Exclusion Criteria

* Smoking \>7 cigarettes per day
* Precious malabsorptive or restrictive intestinal surgery
* Pregnant or breastfeeding
* Recent history of neoplasia (5\<years ago)
* Malabsorptive syndromes
* Inflammatory intestinal disease
* Established organ disfunction
* Allergy to acetaminophen
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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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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Naji Abumrad

Professor of Surgery, Chairman Department of Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Naji Abumrad, 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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Flynn CR, Tamboli RA, Antoun J, Sidani RM, Williams B, Spann MD, English WJ, Welch EB, Sundaresan S, Abumrad NN. Caloric Restriction and Weight Loss Are Primary Factors in the Early Tissue-Specific Metabolic Changes After Bariatric Surgery. Diabetes Care. 2022 Aug 1;45(8):1914-1916. doi: 10.2337/dc22-0069.

Reference Type DERIVED
PMID: 35724307 (View on PubMed)

Other Identifiers

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R01DK091748

Identifier Type: NIH

Identifier Source: secondary_id

View Link

#111237

Identifier Type: -

Identifier Source: org_study_id

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