Insulin Resistance Clinical Trial
Official title:
Does Vitamin D3 (Cholecalciferol) Supplementation Change Insulin Resistance in Patients With Chronic Kidney Disease?
The purpose of this study is to evaluate the impact of vitamin D3 supplementation on the insulin resistance in non-diabetic patients with chronic kidney disease (CKD) stages 3-4, vitamin D deficiency/insufficiency and elevated fasting serum insulin levels.
Insulin resistance, i.e., reduction in insulin responsiveness with a decrease in glucose
uptake in insulin target tissues (muscle and adipose tissue) is common in end-stage renal
disease (ESRD), but is also present at earlier stages of renal disease with mild-moderate
renal function impairment as well as in microalbuminuria and nephrotic syndrome.
Population-based cross-sectional studies have shown that low levels of vitamin D (25(OH)
vitamin D) is associated with impaired glucose tolerance in subjects with normal renal
function and that reduced renal function and 25(OH) vitamin D deficiency are independently
associated with insulin resistance.
Vitamin D has well-known effects on calcium metabolism and skeletal mineralisation but
recent experimental studies suggest that vitamin D in addition reduces several inflammatory
mediators that are of importance in the development and progression of renal disease which
also associated with insulin resistance such as TNF-α and IL-6.
This is a prospective, single-blind, explorative, randomized, placebo-controlled,
single-centre, two-way cross-over study with two treatment periods of 10 weeks separated by
a washout period of 6 weeks. Non-diabetic patients with chronic kidney disease (CKD) stage 3
and 4 (GFR 15-60 ml/min/1.73m2) who have low serum 25-OH-vitamin D levels (< 30 ng/mL) and
elevated fasting serum insulin levels (>10 IU/L) will be randomized to receive either
vitamin D3 (cholecalciferol) 3200U orally (tablets) daily or placebo.
Approximately 24 patients are going to complete the study. A pre-entry wash-out period of 6
weeks is needed for patents already on vitamin D treatment. An in vivo assessment of insulin
secretion and insulin sensitivity will be made by insulin-glucose clamp at the end of each
treatment period.
;
Allocation: Randomized, Endpoint Classification: Pharmacodynamics Study, Intervention Model: Crossover Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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