Effect of Ghrelin on Glucose Metabolism After Bariatric Surgery

NCT ID: NCT02953587

Last Updated: 2023-02-08

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

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-30

Study Completion Date

2023-01-30

Brief Summary

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The purpose of this study is to determine if the altered nutrient exposure to the GI tract after bariatric surgery reveals a negative incretin effect of ghrelin.

Detailed Description

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Conditions

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Obesity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

SINGLE

Participants

Study Groups

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Vertical Sleeve Gastrectomy (VSG) NJ/PO

Patients that are undergoing routine VSG will be studied preoperatively, and at 1 month postoperatively. Each time point will have two study visits with a cross-over design. The first visit at each time point will be randomized to a human ghrelin or a saline infusion, with the alternate infusion at the second visit. At each study visit, an Oral Glucose Tolerance Test (OGTT) will be performed by administering glucose through a nasojejunal (NJ) feeding tube preoperatively and orally (PO) postoperatively.

Group Type EXPERIMENTAL

Oral Glucose Tolerance Test (OGTT)

Intervention Type PROCEDURE

Subjects will have glucose administered enterally and blood will be drawn to measure its kinetics.

Human Ghrelin

Intervention Type DRUG

Human ghrelin will be administered by IV at two of the four study visits in conjunction with the OGTT.

Saline

Intervention Type DRUG

Saline Infusion will be administered by IV at two of the four study visits in conjunction with the OGTT to serve as a placebo comparator for the human ghrelin infusions.

Roux-en-Y Gastric Bypass (RYGB) NJ/PO

Patients that are undergoing routine RYGB will be studied preoperatively, and at 1 month postoperatively. Each time point will have two study visits with a cross-over design. The first visit at each time point will be randomized to a human ghrelin or a saline infusion, with the alternate infusion at the second visit. At each study visit, an Oral Glucose Tolerance Test (OGTT) will be performed by administering glucose through a nasojejunal (NJ) feeding tube preoperatively and orally (PO) postoperatively.

Group Type EXPERIMENTAL

Oral Glucose Tolerance Test (OGTT)

Intervention Type PROCEDURE

Subjects will have glucose administered enterally and blood will be drawn to measure its kinetics.

Human Ghrelin

Intervention Type DRUG

Human ghrelin will be administered by IV at two of the four study visits in conjunction with the OGTT.

Saline

Intervention Type DRUG

Saline Infusion will be administered by IV at two of the four study visits in conjunction with the OGTT to serve as a placebo comparator for the human ghrelin infusions.

Vertical Sleeve Gastrectomy (VSG) PO/PO

Patients that are undergoing routine VSG will be studied preoperatively, and at 1 month postoperatively. Each time point will have two study visits with a cross-over design. The first visit at each time point will be randomized to a human ghrelin or a saline infusion, with the alternate infusion at the second visit. At each study visit, an Oral Glucose Tolerance Test (OGTT) will be performed.

Group Type EXPERIMENTAL

Oral Glucose Tolerance Test (OGTT)

Intervention Type PROCEDURE

Subjects will have glucose administered enterally and blood will be drawn to measure its kinetics.

Human Ghrelin

Intervention Type DRUG

Human ghrelin will be administered by IV at two of the four study visits in conjunction with the OGTT.

Saline

Intervention Type DRUG

Saline Infusion will be administered by IV at two of the four study visits in conjunction with the OGTT to serve as a placebo comparator for the human ghrelin infusions.

Roux-en-Y Gastric Bypass (RYGB) PO/PO

Patients that are undergoing routine RYGB will be studied preoperatively, and at 1 month postoperatively. Each time point will have two study visits with a cross-over design. The first visit at each time point will be randomized to a human ghrelin or a saline infusion, with the alternate infusion at the second visit. At each study visit, an Oral Glucose Tolerance Test (OGTT) will be performed.

Group Type EXPERIMENTAL

Oral Glucose Tolerance Test (OGTT)

Intervention Type PROCEDURE

Subjects will have glucose administered enterally and blood will be drawn to measure its kinetics.

Human Ghrelin

Intervention Type DRUG

Human ghrelin will be administered by IV at two of the four study visits in conjunction with the OGTT.

Saline

Intervention Type DRUG

Saline Infusion will be administered by IV at two of the four study visits in conjunction with the OGTT to serve as a placebo comparator for the human ghrelin infusions.

Interventions

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Oral Glucose Tolerance Test (OGTT)

Subjects will have glucose administered enterally and blood will be drawn to measure its kinetics.

Intervention Type PROCEDURE

Human Ghrelin

Human ghrelin will be administered by IV at two of the four study visits in conjunction with the OGTT.

Intervention Type DRUG

Saline

Saline Infusion will be administered by IV at two of the four study visits in conjunction with the OGTT to serve as a placebo comparator for the human ghrelin infusions.

Intervention Type DRUG

Other Intervention Names

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OGTT Ghrelin NaCl, sodium chloride

Eligibility Criteria

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Inclusion Criteria

* BMI ≥ 35 kg/m2
* Age 21-65 years
* Weight ≤ 200 kg

Exclusion Criteria

* Type 2 or Type 1 diabetes
* Medications that alter insulin sensitivity or carbohydrate metabolism
* Positive pregnancy test
* Known history of intestinal diseases including, but not limited to, inflammatory bowel disease (e.g. Chronic Ulcerative Colitis, Crohn's disease, celiac sprue)
* Prior gastric or intestinal surgery or pancreas resection
* History of cardiovascular disease, including but not limited to: myocardial infarction, angioplasty, arrhythmia, uncontrolled hypertension
* History of chronic kidney disease or renal insufficiency; creatinine \> 1.8 mg/dl.
* History of chronic liver disease, including but not limited to: cirrhosis, hepatitis, portal hypertension; AST and/or ALT \> 2x the upper limit of normal.
* Abnormal ECG
Minimum Eligible Age

21 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 Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Naji Abumrad

John L. Sawyers Professor of Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

Countries

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United States

Other Identifiers

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R01DK091748

Identifier Type: NIH

Identifier Source: secondary_id

View Link

111237-Protocol II

Identifier Type: -

Identifier Source: org_study_id

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