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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03526445
Other study ID # H-18003696
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date May 1, 2018
Est. completion date June 12, 2019

Study information

Verified date May 2018
Source Steno Diabetes Center Copenhagen
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The objective of the study is to investigate how exogenously administered glucagon affects hepatic lipid, glucose and protein metabolism as well as appetite, food intake and resting energy expenditure.


Description:

Most research has focused on the role of the pancreatic hormone, insulin, and insulin signalling (or lack of) in the development of NAFLD. However, increasing evidence suggest that the other major gluco-regulatory pancreatic hormone glucagon is also implicated in lipid metabolism and recent human data from studies investigating the effect of glucagon receptor antagonism suggest that glucagon signalling may be essential for maintaining a fat-free liver. This, combined with observations of increased degree of hepatic steatosis in patients after total pancreatectomy, who are devoid of pancreatic glucagon and typically are lean and peripherally insulin sensitive, suggests that glucagon may play a hitherto unrecognised role in the pathophysiology of NAFLD.

The hypothesis of the study is that exogenously delivered glucagon will drive hepatic metabolism in a lipolytic direction and increase resting energy expenditure without affecting appetite and food intake.

The acute effects of exogeneous glucagon infusion on hepatic lipid metabolism will be evaluated in patients after total pancreatectomy (no endogenous pancreatic hormones), in patients with type 1 diabetes (no endogenous insulin production) and in healthy controls (preserved endogenous pancreatic hormones).


Recruitment information / eligibility

Status Completed
Enrollment 27
Est. completion date June 12, 2019
Est. primary completion date June 12, 2019
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 30 Years to 80 Years
Eligibility Inclusion Criteria:

Pancreatectomised patients

- Patients who have undergone total pancreatectomy

- Caucasian between 30-80

- Blood haemoglobin >7.0 mmol/l for males and >6.5 mmol/l for females

- Informed consent

Patients with type 1 diabetes

- Patients with C-peptide negative type 1 diabetes

- Caucasian between 30-80

- Blood haemoglobin >7.0 mmol/l for males and >6.5 mmol/l for females

- Informed consent

Healthy controls

- Normal fasting plasma glucose (< 7 mmol/l) and normal HbA1c (< 6.5 %) (30,31)

- Normal blood haemoglobin (>8.3 mmol/l for males and >7.3 mmol/l for females)

- Caucasian between 30-80

- Informed consent

Exclusion Criteria:

All subjects

- Inflammatory bowel disease

- Gastrointestinal resection (other than the gastro-duodenectomy performed in connection with total pancreatectomy) and/or ostomy

- Nephropathy (eGFR < 60 ml/min/1.73 m² and/or urine albumin > 20 mg/L)

- Known liver disease (excluding non-alcoholic fatty liver disease)

- Severe lung disease

- Pregnancy and/or breastfeeding

- Uncontrolled hypertension and/or significant cardiovascular disease

- Treatment with drugs with potential steatogenic side-effects within three months prior to inclusion

- Alcohol consumption above 21 units/week for men and 14 units/week for women

- Any condition that the investigator feels would interfere with the safety of the trial participation or the safety of the subject.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Glucagon
Glucagon (4 ng/kg/min)
Saline
Placebo

Locations

Country Name City State
Denmark Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen Hellerup

Sponsors (2)

Lead Sponsor Collaborator
Steno Diabetes Center Copenhagen University of Copenhagen

Country where clinical trial is conducted

Denmark, 

Outcome

Type Measure Description Time frame Safety issue
Primary Hepatic lipid metabolism evaluated using isotopic labelled tracer kinetics: lipolysis, ketogenesis, very low-density lipoprotein (VLDL) secretion and free fatty acid (FFA) re-esterification rate -120,-30,-15,0,30,60,90,120,135,150 minutes
Secondary Changes in plasma concentration of lipids Total cholesterol, VLDL, LDL, HDL, FFA 0, 60,150 minutes
Secondary Changes in plasma concentration of amino acids 0, 60, 120, 150 minutes
Secondary Changes in plasma concentration of fibroblast growth factor 21 (FGF-21) -120,0,150 minutes
Secondary Endogenous glucose production Measured by glucose tracer -120,-30,-15,0,30,60,90,120,135,150 minutes
Secondary Changes in resting energy expenditure and oxidation rate Measured by indirect calorimetry 0, 150 minutes
Secondary Food intake Ad libitum meal 30 minutes (150-180) minutes
Secondary Changes in appetite sensation Visual analogue scale 0,30,60,90,120,150 minutes
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