The Role of FTO Gene Polymorphism and Insulin Preparation in Obesity in Children With Type 1 Diabetes Mellitus

NCT01279161 | Completed DMC

• 1 other identifier: FTO DIAB
• Study Type: observational
• Target: 2,000
• Locations: 1 country
• Sites: 6

Brief Summary

The project aims at assessment of the effect of the FTO gene polymorphism and the type of treatment on the development of overweight/obesity and features of metabolic syndrome in children with type 1 diabetes. Gene polymorphism including some genetic variants may predispose to the development of cardiovascular diseases and their complications. The A allele of the FTO gene predisposing to obesity occurs in approximately 40% of the European population and each copy of this allele can increase BMI by 0.1 Z-score i.e. by 0.4 kg/m2. Insulin therapy in diabetic patients may result in excess body weight gain. Therefore we need studies involving large groups of children and assessing cardiovascular risk factors in type 1 diabetes along with their genetic associations. Patients: The study will include 1500 children with type 1 diabetes, aged 6-18 years. Reference group will be made of 1500 children in whom type 1 diabetes was excluded. The following variables will be assessed in the treatment group: 1) Anthropometric data and questionnaire data: age, sex, body height and weight, body mass index (BMI), waist and hip circumferences, arm and thigh circumferences, family history of overweight/obesity, type 1 or 2 diabetes or cardiovascular disease, 2) Primary disease characteristics: age of the disease onset, treatment regimen, mean daily insulin consumption per kg body weight, brands of insulin products, glycated haemoglobin, BMI from the first 3-6 months following diabetes onset, diet, conversion of these data into actual and ideal calorie intake 3) Laboratory data - lipid profile and blood pressure (average of three measurements). Methodology: Gene polymorphism analysis in the extracted DNA will be made with the real-time PCR method using TaqMan 7900 HT by Applied Biosystems. Correlations between the FTO gene polymorphism and clinical variables such as BMI (including BMI increase since the disease onset), body weight and height, waist and hip circumferences, arm and thigh circumferences, and blood pressure will be assessed by a professional statistician with a specially dedicated software. Moreover parameters such as diet and metabolic control will be assessed. As regards insulin therapy the following variables will be analysed: insulin injection device, therapy regimen (intensive versus functional; brands and types of insulin products: human insulin versus insulin analogue), consumption of insulin. All of the above listed variables will be correlated with the genotypes found in the gene polymorphism analysis. The study has been approved by Bioethics Committee of the Medical University in Białystok. Results: The authors of the project expect that the effect of the FTO gene polymorphism on overweight/obesity and features of metabolic syndrome in children with type 1 diabetes will be shown. Moreover the project will enable assessment of the effect of the therapeutic regimen, including the type of insulin product, on body weight increase in the course of type 1 diabetes treatment in the context of the FTO gene polymorphism. Confirmation of the above associations and identification of a group at risk of excess body weight increase in the course of insulin therapy may help physicians, parents and patients to avoid this complication. Therefore clinical benefit of this project will include identification - based on the genetic assays results - of a group of type 1 diabetic children particularly likely to develop overweight, obesity and other cardiovascular risk factors.

Conditions

Type 1 Diabetes Mellitus

Keywords

overweight, obesity, children, insulin, pump therapy, FTO

Outcome Measures

Primary Outcomes (1)

• Identification of the effect of the FTO gene polymorphism on the development of overweight/obesity in insulin treated children

  one year

Secondary Outcomes (4)

• • Identification of the effect of the following factors: sex, age, duration of disease, therapy regimen, type of insulin product and degree of metabolic control on the development of overweight/ obesity in insulin treated children

  one year

• • Identification of the effect of genetic polymorphism of the FTO gene on the incidence of metabolic syndrome features in insulin treated children.

  one year

• • Identification of the effect of genetic polymorphism of the FTO gene on the incidence of overweight, obesity and metabolic syndrome features in children without diabetes.

  one year

• • Comparison of frequency distribution of FTO gene polymorphism involved in the pathogenesis of obesity in children with diabetes versus children without diabetes.

  one year

Study Arms (2)

diabetes

The study will include 1500 children with type 1 diabetes, aged 6-18 years. These will be patients from Diabetes Outpatient Clinics and patients hospitalized in Departments of Paediatrics, Endocrinology and Diabetology in University and Municipal Hospitals from Poland (Białystok, Warszawa, Łódź, Gdańsk, Wrocław, Katowice).

control

Reference group will be made of 1500 children from the above mentioned Clinics and Departments in whom type 1 diabetes was excluded. In these children diagnostics procedures will be conducted for reasons other than body weigh related diseases (excluding simple obesity). The children will not receive any treatment that might influence their body weight.

Eligibility Criteria

• Age: 6 Years - 18 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

The study will include 1500 children with type 1 diabetes, aged 6-18 years. These will be patients from Diabetes Outpatient Clinics and patients hospitalized in Departments of Paediatrics, Endocrinology and Diabetology in University and Municipal Hospitals from all over Poland (Białystok, Warszawa, Gdańsk, Katowice, Wrocław). Reference group will be made of 1500 children from the above mentioned Clinics and Departments in whom type 1 diabetes was excluded. In these children diagnostics procedures will be conducted for reasons other than body weigh related diseases (excluding simple obesity). The children will not receive any treatment that might influence their body weight.

You may qualify if:

• children of Polish origin
• diagnosed with type 1 diabetes (defined according to the ADA 2010)
• treated with insulin therapy for at least 1 year
• aged ≥ 6 \< 18 years
• receiving the same treatment regimen for at least one year
• insulin requirement of \> 0.5 U/kg/daily

You may not qualify if:

• no consent given by parents/guardians
• chromosome disorders
• autoimmune diseases
• coeliac disease (biopsy-proven)
• thyroid hormone disorders (but not the presence of antithyroid antibodies)
• treatment that might influence body weight
• newly diagnosed diabetes (either type 1, 2, 3 or other types of diabetes)

Sponsors & Collaborators

• University of Bialystok: lead

Study Sites (6)

Department of Pediatrics, Endocrinology and Diabetology, Medical University

Wroclaw, Lower Silesian Voivodeship, 50-376, Poland

Location

Department of Pediatrics, Medical University

Warsaw, Masovian Voivodeship, 01-184, Poland

Location

Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University

Bialystok, Podlaskie Voivodeship, 15-089, Poland

Location

Department of Pediatrics, Hematology, Oncology and Endocrinology, Medical University

Gdansk, Pomeranian Voivodeship, 80-211, Poland

Location

Department of Pediatrics, Endocrinology and Diabetology, Medical University

Katowice, Silesian Voivodeship, 40-752, Poland

Location

Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University

Lodz, Łódź Voivodeship, 91-738, Poland

Location

Related Publications (5)

• Timpson NJ, Emmett PM, Frayling TM, Rogers I, Hattersley AT, McCarthy MI, Davey Smith G. The fat mass- and obesity-associated locus and dietary intake in children. Am J Clin Nutr. 2008 Oct;88(4):971-8. doi: 10.1093/ajcn/88.4.971.

  PMID: 18842783 BACKGROUND

• Frayling TM, Timpson NJ, Weedon MN, Zeggini E, Freathy RM, Lindgren CM, Perry JR, Elliott KS, Lango H, Rayner NW, Shields B, Harries LW, Barrett JC, Ellard S, Groves CJ, Knight B, Patch AM, Ness AR, Ebrahim S, Lawlor DA, Ring SM, Ben-Shlomo Y, Jarvelin MR, Sovio U, Bennett AJ, Melzer D, Ferrucci L, Loos RJ, Barroso I, Wareham NJ, Karpe F, Owen KR, Cardon LR, Walker M, Hitman GA, Palmer CN, Doney AS, Morris AD, Smith GD, Hattersley AT, McCarthy MI. A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science. 2007 May 11;316(5826):889-94. doi: 10.1126/science.1141634. Epub 2007 Apr 12.

  PMID: 17434869 BACKGROUND

• Reinehr T, Holl RW, Roth CL, Wiesel T, Stachow R, Wabitsch M, Andler W; DPV-Wiss Study Group. Insulin resistance in children and adolescents with type 1 diabetes mellitus: relation to obesity. Pediatr Diabetes. 2005 Mar;6(1):5-12. doi: 10.1111/j.1399-543X.2005.00093.x.

  PMID: 15787895 BACKGROUND

• Luczynski W, Szypowska A, Glowinska-Olszewska B, Bossowski A. Overweight, obesity and features of metabolic syndrome in children with diabetes treated with insulin pump therapy. Eur J Pediatr. 2011 Jul;170(7):891-8. doi: 10.1007/s00431-010-1372-7. Epub 2010 Dec 8.

  PMID: 21140273 BACKGROUND

• Luczynski W, Fendler W, Ramatowska A, Szypowska A, Szadkowska A, Mlynarski W, Chumiecki M, Jarosz-Chobot P, Chrzanowska J, Noczynska A, Brandt A, Mysliwiec M, Glowinska-Olszewska B, Bernatowicz P, Kowalczuk O, Bossowski A. Polymorphism of the FTO Gene Influences Body Weight in Children with Type 1 Diabetes without Severe Obesity. Int J Endocrinol. 2014;2014:630712. doi: 10.1155/2014/630712. Epub 2014 Aug 19.

  PMID: 25214838 DERIVED

Biospecimen

Retention: SAMPLES WITH DNA

Small amount of peripheral blood for isolation of DNA for assessment of FTO polymorphism.

MeSH Terms

Conditions

Diabetes Mellitus, Type 1; Overweight; Obesity; Insulin Resistance

Condition Hierarchy (Ancestors)

Diabetes Mellitus; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Autoimmune Diseases; Immune System Diseases; Overnutrition; Nutrition Disorders; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Hyperinsulinism

Study Officials

• Wlodzimierz Luczynski, Ass. Prof.

  Medical University of Bialystok, Poland

  STUDY CHAIR

• Adam Kretowski, Prof

  Medical University of Bialystok, Poland

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: January 18, 2011
• First Posted: January 19, 2011
• Study Start: December 1, 2010
• Primary Completion: December 1, 2014
• Study Completion: December 1, 2014
• Last Updated: December 2, 2014

Record last verified: 2014-12

Locations

PL (6)