Effects of Insulin Sensitizers in Subjects With Impaired Glucose Tolerance

NCT00108615 | Completed Phase 4 DMC

• 1 other identifier: CLIN-013-0S3
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

Subjects with impaired glucose tolerance will be randomized to receive pioglitazone or metformin for 10 weeks. Measurements of insulin sensitivity, body composition, glucose tolerance, and muscle lipid accumulation will be performed. Adipose tissue and muscle biopsies are performed. The goal of the study is to determine whether the lipotoxiciy of impaired glucose tolerance is ameliorated by pioglitazone.

Conditions

Glucose Metabolism Disorders; Diabetes

Outcome Measures

Primary Outcomes (1)

• Effects of pioglitazone and metformin on ectopic lipid accumulation

  4 yr

Secondary Outcomes (1)

• Effects of pioglitazone and metformin on beta cell responsiveness

  4 yr

Study Arms (2)

1

EXPERIMENTAL

pioglitazone

Drug: Metformin; Drug: Pioglitazone; Radiation: CT scans; Procedure: Oral glucose tolerance test

2

ACTIVE COMPARATOR

metformin

Drug: Metformin; Drug: Pioglitazone; Radiation: CT scans; Procedure: Oral glucose tolerance test

Interventions

Metformin DRUG

1

Pioglitazone DRUG

1

CT scans RADIATION

To measure changes in adipose tissue volumes

1; 2

Oral glucose tolerance test PROCEDURE

To detect a change in glucose tolerance

1; 2

Eligibility Criteria

• Age: 35 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Impaired glucose tolerance
• Body mass index (BMI) of 28-38

You may not qualify if:

• Heart disease
• Renal disease
• Liver disease

Sponsors & Collaborators

• US Department of Veterans Affairs: lead

Study Sites (1)

Central Arkansas Veterans HCS

Little Rock, Arkansas, 72205, United States

Location

Related Publications (13)

• Rasouli N, Raue U, Miles LM, Lu T, Di Gregorio GB, Elbein SC, Kern PA. Pioglitazone improves insulin sensitivity through reduction in muscle lipid and redistribution of lipid into adipose tissue. Am J Physiol Endocrinol Metab. 2005 May;288(5):E930-4. doi: 10.1152/ajpendo.00522.2004. Epub 2005 Jan 4.

  PMID: 15632102 RESULT

• Di Gregorio GB, Yao-Borengasser A, Rasouli N, Varma V, Lu T, Miles LM, Ranganathan G, Peterson CA, McGehee RE, Kern PA. Expression of CD68 and macrophage chemoattractant protein-1 genes in human adipose and muscle tissues: association with cytokine expression, insulin resistance, and reduction by pioglitazone. Diabetes. 2005 Aug;54(8):2305-13. doi: 10.2337/diabetes.54.8.2305.

  PMID: 16046295 RESULT

• Bodles AM, Varma V, Yao-Borengasser A, Phanavanh B, Peterson CA, McGehee RE Jr, Rasouli N, Wabitsch M, Kern PA. Pioglitazone induces apoptosis of macrophages in human adipose tissue. J Lipid Res. 2006 Sep;47(9):2080-8. doi: 10.1194/jlr.M600235-JLR200. Epub 2006 Jun 23.

  PMID: 16799131 RESULT

• Yue L, Rasouli N, Ranganathan G, Kern PA, Mazzone T. Divergent effects of peroxisome proliferator-activated receptor gamma agonists and tumor necrosis factor alpha on adipocyte ApoE expression. J Biol Chem. 2004 Nov 12;279(46):47626-32. doi: 10.1074/jbc.M408461200. Epub 2004 Aug 31.

  PMID: 15339912 RESULT

• Rasouli N, Yao-Borengasser A, Miles LM, Elbein SC, Kern PA. Increased plasma adiponectin in response to pioglitazone does not result from increased gene expression. Am J Physiol Endocrinol Metab. 2006 Jan;290(1):E42-E46. doi: 10.1152/ajpendo.00240.2005. Epub 2005 Aug 23.

  PMID: 16118250 RESULT

• Bodles AM, Banga A, Rasouli N, Ono F, Kern PA, Owens RJ. Pioglitazone increases secretion of high-molecular-weight adiponectin from adipocytes. Am J Physiol Endocrinol Metab. 2006 Nov;291(5):E1100-5. doi: 10.1152/ajpendo.00187.2006. Epub 2006 Jun 27.

  PMID: 16803857 RESULT

• Ranganathan G, Unal R, Pokrovskaya I, Yao-Borengasser A, Phanavanh B, Lecka-Czernik B, Rasouli N, Kern PA. The lipogenic enzymes DGAT1, FAS, and LPL in adipose tissue: effects of obesity, insulin resistance, and TZD treatment. J Lipid Res. 2006 Nov;47(11):2444-50. doi: 10.1194/jlr.M600248-JLR200. Epub 2006 Aug 7.

  PMID: 16894240 RESULT

• Rasouli N, Kern PA, Reece EA, Elbein SC. Effects of pioglitazone and metformin on beta-cell function in nondiabetic subjects at high risk for type 2 diabetes. Am J Physiol Endocrinol Metab. 2007 Jan;292(1):E359-65. doi: 10.1152/ajpendo.00221.2006. Epub 2006 Sep 12.

  PMID: 16968813 RESULT

• Yao-Borengasser A, Rasouli N, Varma V, Miles LM, Phanavanh B, Starks TN, Phan J, Spencer HJ 3rd, McGehee RE Jr, Reue K, Kern PA. Lipin expression is attenuated in adipose tissue of insulin-resistant human subjects and increases with peroxisome proliferator-activated receptor gamma activation. Diabetes. 2006 Oct;55(10):2811-8. doi: 10.2337/db05-1688.

  PMID: 17003347 RESULT

• Varma V, Yao-Borengasser A, Rasouli N, Bodles AM, Phanavanh B, Lee MJ, Starks T, Kern LM, Spencer HJ 3rd, McGehee RE Jr, Fried SK, Kern PA. Human visfatin expression: relationship to insulin sensitivity, intramyocellular lipids, and inflammation. J Clin Endocrinol Metab. 2007 Feb;92(2):666-72. doi: 10.1210/jc.2006-1303. Epub 2006 Nov 7.

  PMID: 17090638 RESULT

• Wolins NE, Quaynor BK, Skinner JR, Tzekov A, Croce MA, Gropler MC, Varma V, Yao-Borengasser A, Rasouli N, Kern PA, Finck BN, Bickel PE. OXPAT/PAT-1 is a PPAR-induced lipid droplet protein that promotes fatty acid utilization. Diabetes. 2006 Dec;55(12):3418-28. doi: 10.2337/db06-0399.

  PMID: 17130488 RESULT

• Yao-Borengasser A, Varma V, Bodles AM, Rasouli N, Phanavanh B, Lee MJ, Starks T, Kern LM, Spencer HJ 3rd, Rashidi AA, McGehee RE Jr, Fried SK, Kern PA. Retinol binding protein 4 expression in humans: relationship to insulin resistance, inflammation, and response to pioglitazone. J Clin Endocrinol Metab. 2007 Jul;92(7):2590-7. doi: 10.1210/jc.2006-0816. Epub 2007 Jun 26.

  PMID: 17595259 RESULT

• Varma V, Yao-Borengasser A, Bodles AM, Rasouli N, Phanavanh B, Nolen GT, Kern EM, Nagarajan R, Spencer HJ 3rd, Lee MJ, Fried SK, McGehee RE Jr, Peterson CA, Kern PA. Thrombospondin-1 is an adipokine associated with obesity, adipose inflammation, and insulin resistance. Diabetes. 2008 Feb;57(2):432-9. doi: 10.2337/db07-0840. Epub 2007 Dec 5.

  PMID: 18057090 RESULT

MeSH Terms

Conditions

Glucose Metabolism Disorders; Diabetes Mellitus

Interventions

Metformin; Pioglitazone; Glucose Tolerance Test

Condition Hierarchy (Ancestors)

Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases

Intervention Hierarchy (Ancestors)

Biguanides; Guanidines; Amidines; Organic Chemicals; Thiazolidinediones; Thiazoles; Sulfur Compounds; Azoles; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Blood Chemical Analysis; Clinical Chemistry Tests; Clinical Laboratory Techniques; Diagnostic Techniques and Procedures; Diagnosis; Diagnostic Techniques, Endocrine; Investigative Techniques

Study Officials

• Philip A Kern, MD

  Central Arkansas Veterans HCS

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: BASIC SCIENCE
• Intervention Model: PARALLEL
• Sponsor Type: FED

Study Record Dates

• First Submitted: April 15, 2005
• First Posted: April 18, 2005
• Study Start: January 1, 2004
• Primary Completion: April 1, 2007
• Study Completion: December 1, 2007
• Last Updated: April 25, 2008

Record last verified: 2008-04

Locations

US (1)