Glucose Metabolism Disorders Clinical Trial
Official title:
Exploring the Association Between Phthalates Exposure, Measured Through Their Urinary Metabolites, and Renal Function Impairment in Individuals With TYpe 2 Diabetes - SGLT2 Subprotocol
In this open clinical trial, 30 subjects with inadequately controlled T2D and eligible, as per good clinical practice, for therapy with SGLT-2 inhibitor, will be randomized to receive a SGLT-2 inhibitor vs other oral-antidiabetic drugs (OADs) therapy for 3 months. Measures will be performed at baseline, after 2 days, after one month and at the end of the study protocol, as per good clinical practice
- Total concentrations of MEHP, MEOHP and MEHHP will be quantified, in the laboratories of
the Institute of Clinical Physiology, National Research Council, Pisa, in a spot morning
urine sample by ultra-HPLC coupled with electrospray ionization/quadrupole
time-of-flight mass spectrometry (Agilent UHPLC 1290 infinity coupled to an Agilent 6540
MS-QTOF, Santa Clara, CA) using stable isotope labeled substrates, i.e. MEHP
(ring-1,2-13C2, dicarboxyl-13C2), MEHHP, MEHHP 13C4, MEOHP and MEOHP 13C4 that will be
purchased from Cambridge Isotope Laboratories (Tewksbury, MA).
- Urinary creatinine concentrations will be measured to adjust urinary concentrations of
DEHP metabolite (Beckman Coulter AU400, Brea, CA), thus minimizing the influence of urine
volume.
- Serum and urinary inflammatory markers and adipocytokines will be quantitatively
determined using sandwich enzyme-linked immunosorbent assays kits according to the
manufacturer's instructions. Optical density will be measured using a microplate reader.
- Serum and urinary markers of oxidative stress will be measured by gold standard
techniques. In detail, MDA will be quantified by TBARS reactive substances measured by
optical density; GSH-Px by a specific assay kit according to the manufacturer's
instruction; SOD activity will be determined using a specific SOD kit; urinary
8-isoprostane concentration will be measured by a specific affinity sorbent. (Cayman
Chemical, Ann Harbor, MI, USA) according to the manufacturer's instructions.
- To analyze mitochondrial DNA we will apply a triplex design previously reported to
amplify mitochondria loci located within the MinorArc and MajorArc, respectively. To
assess nuclear DNA, we will use RNase P Copy Number Reference.
- The phthalates-free diet will be self-administered by the individuals under
intervention, following a set of instruction and rules provided by the physicians based
on the current literature data.
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