Effect of Hypothyroidism on Brown Adipose Tissue

Hypothyroidism Clinical Trial

Official title:

Effect of Restoration of Euthyroidism in Patients With Primary Hypothyroidism on Brown Adipose Tissue Thermogenesis - the ThyroBAT Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02364102
• Other study ID #: EKNZ 2015-028
• Status: Completed
• Phase: N/A
• First received: February 9, 2015
• Last updated: August 25, 2017
• Start date: April 2015
• Est. completion date: August 2017

Study information

• Verified date: August 2017
• Source: University Hospital, Basel, Switzerland
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The investigators aim to study whether hypothyroidism negatively affects Brown adipose tissue (BAT) function in humans and whether BAT function can be restored to normal by thyroid hormone supplementation.

Description:

Hypothyroidism is a frequent endocrine disorder, the prevalence of subclinical disease being 4.3% and of overt disease being 0.3%. Patients suffering from hypothyroidism frequently complain of increased cold sensitivity and involuntary weight gain, indicating changes in energy expenditure and response to cold challenge.

Recently, brown adipose tissue (BAT) has regained attention as an energy expending tissue. While it was previously thought to be of no or negligible relevance in human adults, recent studies clearly demonstrated the presence and metabolic activity of BAT in human adults. Upon activation of BAT by the sympathetic nervous system intracellular lipid stores are rapidly depleted. The generated free fatty acids fuel beta-oxidation and the respiratory chain within the mitochondria and activate at the same time uncoupling protein 1 (UCP1). This protein acts as a protonophore, allowing the flux of protons along the electrochemical gradient into the inner mitochondrial matrix instead of transferring their energy to adenosine triphosphate (ATP)-synthase. The short circuiting of the oxidative phosphorylation within the mitochondria leads to highly active cellular respiration and generation of heat. Basic research highlights the importance of thyroid hormone in the development and function of BAT.

It has recently been shown that hyperthyroidism exerts activating effects on BAT in adult humans.

The investigators aim to study whether hypothyroidism negatively affects BAT function in humans and whether BAT function can be restored to normal by thyroid hormone supplementation.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 42
• Est. completion date: August 2017
• Est. primary completion date: August 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

• informed consent

• Serum thyroid-stimulating hormone (TSH) > 4.5 milli-International unit (mIU)/l

• body mass index (weight/height(m)²) 17.5 to 30 kg/m²

Exclusion Criteria:

• known concomitant disease influencing thyroid hormone metabolism

• chronic heart failure

• liver cirrhosis

• severe kidney failure

• metastasized cancer, except for thyroid cancer

• known hypersensitivity to cold, e.g. primary or secondary Raynaud's syndrome

• abuse of alcohol or illicit drugs

• Women who are pregnant or breast feeding

• Intention to become pregnant during the course of the study

• Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant

• Participation in another study with investigational drug within the 30 days preceding and during the present study

• Previous enrolment into the current study

Related Conditions & MeSH terms

• Hypothyroidism

Locations

Country	Name	City	State
Switzerland	University Hospital Basel, Department of Endocrinology	Basel	BS

Sponsors (1)

Lead Sponsor	Collaborator
University Hospital, Basel, Switzerland

Country where clinical trial is conducted

Switzerland, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	difference in cold induced thermogenesis between baseline and restoration of euthyroidism, assessed as the increase in resting energy expenditure after a mild cold stimulus determined by indirect calorimetry		before and after 3 months after restoration of euthyroidism
Secondary	difference in supraclavicular skin temperature (before and after cold exposure)		before and after 3 months after restoration of euthyroidism
Secondary	levels of Irisin in serum		before and after 3 months after restoration of euthyroidism
Secondary	patient's perception of cold		before and after 3 months after restoration of euthyroidism