NCT02953587

Brief Summary

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.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
70

participants targeted

Target at P50-P75 for phase_1 obesity

Timeline
Completed

Started Sep 2016

Longer than P75 for phase_1 obesity

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

September 1, 2016

Completed
21 days until next milestone

First Submitted

Initial submission to the registry

September 22, 2016

Completed
1 month until next milestone

First Posted

Study publicly available on registry

November 3, 2016

Completed
2.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 21, 2019

Completed
3.4 years until next milestone

Study Completion

Last participant's last visit for all outcomes

January 30, 2023

Completed
Last Updated

February 8, 2023

Status Verified

February 1, 2023

Enrollment Period

3 years

First QC Date

September 22, 2016

Last Update Submit

February 6, 2023

Conditions

Keywords

ObesityBariatric Surgery

Outcome Measures

Primary Outcomes (1)

  • Change in plasma glucose levels with ghrelin versus saline.

    The objective for this protocol is to determine if ghrelin infusion worsens glucose tolerance during jejunal administration of glucose and if the response is difference after bariatric surgery (RYGB or VSG).

    1 month (before and after surgery)

Secondary Outcomes (1)

  • Plasma insulin levels

    1 month (before and after surgery)

Other Outcomes (17)

  • Plasma Levels of GLP-1

    1 month (before and after surgery)

  • Plasma Levels of GIP

    1 month (before and after surgery)

  • Plasma Levels of leptin

    1 month (before and after surgery)

  • +14 more other outcomes

Study Arms (4)

Vertical Sleeve Gastrectomy (VSG) NJ/PO

EXPERIMENTAL

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.

Procedure: Oral Glucose Tolerance Test (OGTT)Drug: Human GhrelinDrug: Saline

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

EXPERIMENTAL

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.

Procedure: Oral Glucose Tolerance Test (OGTT)Drug: Human GhrelinDrug: Saline

Vertical Sleeve Gastrectomy (VSG) PO/PO

EXPERIMENTAL

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.

Procedure: Oral Glucose Tolerance Test (OGTT)Drug: Human GhrelinDrug: Saline

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

EXPERIMENTAL

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.

Procedure: Oral Glucose Tolerance Test (OGTT)Drug: Human GhrelinDrug: Saline

Interventions

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

Also known as: OGTT
Roux-en-Y Gastric Bypass (RYGB) NJ/PORoux-en-Y Gastric Bypass (RYGB) PO/POVertical Sleeve Gastrectomy (VSG) NJ/POVertical Sleeve Gastrectomy (VSG) PO/PO

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

Also known as: Ghrelin
Roux-en-Y Gastric Bypass (RYGB) NJ/PORoux-en-Y Gastric Bypass (RYGB) PO/POVertical Sleeve Gastrectomy (VSG) NJ/POVertical Sleeve Gastrectomy (VSG) PO/PO
SalineDRUG

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.

Also known as: NaCl, sodium chloride
Roux-en-Y Gastric Bypass (RYGB) NJ/PORoux-en-Y Gastric Bypass (RYGB) PO/POVertical Sleeve Gastrectomy (VSG) NJ/POVertical Sleeve Gastrectomy (VSG) PO/PO

Eligibility Criteria

Age21 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

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

You may not qualify if:

  • 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

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Vanderbilt University Medical Center

Nashville, Tennessee, 37232, United States

Location

MeSH Terms

Conditions

Obesity

Interventions

Glucose Tolerance TestGhrelinSodium Chloride

Condition Hierarchy (Ancestors)

OverweightOvernutritionNutrition DisordersNutritional and Metabolic DiseasesBody WeightSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Blood Chemical AnalysisClinical Chemistry TestsClinical Laboratory TechniquesDiagnostic Techniques and ProceduresDiagnosisDiagnostic Techniques, EndocrineInvestigative TechniquesPeptide HormonesHormonesHormones, Hormone Substitutes, and Hormone AntagonistsPeptidesAmino Acids, Peptides, and ProteinsChloridesHydrochloric AcidChlorine CompoundsInorganic ChemicalsSodium Compounds

Study Design

Study Type
interventional
Phase
phase 1
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
BASIC SCIENCE
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
John L. Sawyers Professor of Surgery

Study Record Dates

First Submitted

September 22, 2016

First Posted

November 3, 2016

Study Start

September 1, 2016

Primary Completion

August 21, 2019

Study Completion

January 30, 2023

Last Updated

February 8, 2023

Record last verified: 2023-02

Locations