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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02333591
Other study ID # MZ02
Secondary ID 2013-001240-64
Status Completed
Phase Phase 4
First received
Last updated
Start date July 2016
Est. completion date June 2018

Study information

Verified date March 2019
Source Bispebjerg Hospital
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

GLP-1 is an agent for treatment of type 2 diabetes and may have protective effects on the cardiovascular system. The mechanism is complex and there seems to be a dual function with intact GLP-1 (7-36), acting through the GLP-1 receptor, and the GLP-1 (9-36) metabolite acting independently of the GLP-1 receptor.

Coronary flow reserve (CFR) is the ratio of flow through the coronary arteries during stress to during rest and it reflects coronary microcirculation. Impaired CFR is a strong predictor of poor prognosis of cardiovascular disease.

The aim of the study is to investigate the acute effects of GLP-1 on coronary microcirculation and endothelial function in adults with obesity.


Description:

Several studies have shown beneficial effects of glucagon-like-peptide-1 (GLP-1) on the cardiovascular system. Native GLP-1 is secreted from L-cells in the intestine as GLP-1(7-36) 1 but is rapidly metabolised by the ubiquitous enzyme dipeptidyl-peptidase-4 (DPP4) to the metabolite GLP-1(9-36). However, the physiological effect of GLP-1 on the cardiovascular system is complex and there seems to be a dual function with intact GLP-1 (7-36), acting through the GLP-1 receptor, and the GLP-1 (9-36) metabolite acting independently of the GLP-1 receptor.

The aim of the study is to investigate the acute effects of intact GLP-1 and GLP-1 metabolite on coronary microcirculation and endothelial function in adults.

Method 20 adults with obesity are recruited to a double-blind randomized cross-over study.

The first 10 included adults will receive 2½ hours infusion of intact GLP-1 (7-36) together with a DPP-IV inhibitor and 2½ hours infusion of saline, on two separate occasions. The infusions will be given in randomized order with a minimum of 24 hours washout period.

The next 10 included adults will receive 2½ hours infusion of GLP-1 (9-36) metabolite and 2½ hours infusion of saline. These will also be given in randomized order with a minimum of 24 hours washout period. Endothelial function and CFR will be measured before and after one, respectively two, hours of infusion.

The effect of GLP-1 infusions on microvascular function is evaluated by coronary flow reserve (CFR), the ratio between echocardiographic measured coronary flow velocity in LAD during adenosine induced myocardial hyperaemia and rest. The effect on endothelial function is assessed by flow mediated dilation (FMD).


Recruitment information / eligibility

Status Completed
Enrollment 25
Est. completion date June 2018
Est. primary completion date June 2018
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 35 Years to 70 Years
Eligibility Inclusion Criteria:

- Age 35-70 years

- BMI > 25 kg/m2.

- Central obesity (measured by waist circumference, defined as = 94cm for men and = 80 cm for women)

- Non smokers (6 months abstinent is required)

- Normal creatinine

- For fertile women; negative pregnancy test and use of safe anticonception.

- Speak and understand Danish or English

- Mental ability to follow and understand the study

Exclusion Criteria:

- Known Diabetes

- Known hypertension (untreated hypertension = 160/100 at inclusion is accepted)

- Haemoglobin < 6.5 mmol/l

- Allergy towards Januvia or Exenatide, Adenosin or Glycerylnitrate

- Documented significant stenosis of the left anterior descending artery (LAD) at coronary angiography or CT-angiography or regional dysfunction documented during dipyridamol stress-echocardiography. If stress test at baseline shows significant stenosis the patient will be excluded from the study.

- Pregnancy

- Severe asthma

- Active cancer, severe co-morbidity with limited life-expectancy, severe hepatic co-morbidity, chronic alcohol abuse, atrial fibrillation, chronic or previous acute pancreatitis, inflammatory bowel disease.

Study Design


Related Conditions & MeSH terms

  • Coronary Microvascular Dysfunction

Intervention

Drug:
GlucagonLikePeptide-1 (7-36)
Diluted in saline and human serum albumin, then infused intravenously for 2,5 hours.
GlucagonLikePeptide-1 (9-36)
Diluted in saline and human serum albumin, then infused intravenously for 2,5 hours.
Saline
Infused intravenously for 2,5 hours.

Locations

Country Name City State
Denmark Department of Research in Endocrinology, Bispebjerg University Hospital Copenhagen

Sponsors (2)

Lead Sponsor Collaborator
Mette Zander Hvidovre University Hospital

Country where clinical trial is conducted

Denmark, 

Outcome

Type Measure Description Time frame Safety issue
Primary Coronary Flow Reserve Coronary flow reserve (CFR) reflects microvessel coronary function and is the ratio between echocardiographic measured coronary flow velocity in LAD during adenosine induced myocardial hyperaemia and rest.
The outcome is measured at every infusion/intervention (4 times).
At baseline and after 2 hours of infusion
Secondary Endothelial function (Assessed by Flow Mediated Dilation) Assessed by Flow Mediated Dilation (FMD) The outcome is measured at every infusion/intervention (4 times). At baseline and after 1 hour of infusion
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