Insulin Resistance Clinical Trial
Official title:
Prevalence of Clinical and Laboratory Markers of Hypofibrinolysis in Psychotic Patients
At the Thrombophilia Clinic of the Hospital Federal dos Servidores do Estado do Rio de Janeiro there is a high prevalence of acute psychotic episodes, which allows the investigators to raise the suspicion that the thrombotic tendency or hypofibrinolysis play a role in the onset of the disease. It is striking that most of these patients, after some time on anticoagulants, no longer need to take psychiatric medication.
If the thrombotic tendency plays a significant role in the etiology of psychosis, one would
expect to find ischemic brain injuries in neuroimaging studies, but it does not happen.
Therefore, if there is a correlation between thrombotic tendency-hypofibrinolysis and
psychosis it is likely to occur at the biochemical level, such as in neuronal transmission.
The investigators hypothesis is that mechanisms that inhibit tissue plasminogen activator
(t-PA) and therefore promote hypofibrinolysis, are directly or indirectly involved in the
genesis of psychosis, because t-PA participates in neuronal plasticity and low t-PA levels
are related to dementia.
Hypofibrinolysis due to t-PA inhibition can be seen in:
- Insulin resistance, when the pancreas must produce large amounts of insulin and
proinsulin by feedback. If pancreatic reserve is inadequate, the result is diabetes
mellitus. If the response is adequate, proinsulin stimulates the production of PAI-1
(plasminogen activator inhibitor 1. PAI-1 inhibits the formation of plasmin, whose
function is to dissolve fibrin which makes up the clot. Obesity, certain infections and
inflammations potentiate insulin resistance.
- Antiphospholipid antibody syndrome.
- PAI-1 4G/5G or 4G/4G polymorphism.
Some hypofibrinolysis indicators are:
- severe dysmenorrhea, because strong uterine contractions are necessary to expel
undissolved clots.
- PCOS because plasmin is required to activate some metalloproteinases involved in ovary
remodelling.
- early pregnancy losses, as some metalloproteinases involved in placental angiogenesis
are activated by plasmin,
- preeclampsia and eclampsia, as metalloproteinases that dissolve elastic fibers of the
placental vessels, to create a low flow resistance, are activated by plasmin. Vascular
endothelial growth factor (VEGF), a protein that restricts glomerular porosity, is also
activated by plasmin,
- sudden death and heart attack before age 50 in first degree relatives.
On physical exam, acanthosis, high body mass index, and in women, hirsutism and acne are
indirect indicators of insulin resistance. Livedo suggest antiphospholipid antibody
syndrome.
This study intents to investigate the prevalence of hypofibrinolysis markers, such as PAI-1
4G/5G and 4G/4G, protein S deficiency, antiphospholipid antibodies and prothrombin G20210A,
in psychotic patients.
;
Observational Model: Case Control, Time Perspective: Cross-Sectional
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT03142633 -
MicroRNA as Biomarkers for Development of Metabolic Syndrome in Women With Polycystic Ovary Syndrome
|
||
Recruiting |
NCT04984226 -
Sodium Bicarbonate and Mitochondrial Energetics in Persons With CKD
|
Phase 2 | |
Recruiting |
NCT05354245 -
Using a Complex Carbohydrate Mixture to Steer Fermentation and Improve Metabolism in Adults With Overweight and Prediabetes (DISTAL)
|
N/A | |
Completed |
NCT03383822 -
Regulation of Endogenous Glucose Production by Brain Insulin Action in Insulin Resistance
|
Phase 1/Phase 2 | |
Recruiting |
NCT06007404 -
Understanding Metabolism and Inflammation Risks for Diabetes in Adolescents
|
||
Suspended |
NCT03652987 -
Endocrine and Menstrual Disturbances in Women With Polycystic Ovary Syndrome (PCOS)
|
||
Completed |
NCT04203238 -
Potato Research for Enhancing Metabolic Outcomes
|
N/A | |
Recruiting |
NCT03658564 -
Preoperative Oral Carbohydrate Treatment Minimizes Insulin Resistance
|
N/A | |
Completed |
NCT04183257 -
Effect of Escalating Oral Vitamin D Replacement on HOMA-IR in Vitamin D Deficient Type 2 Diabetics
|
Phase 4 | |
Completed |
NCT04117802 -
Effects of Maple Syrup on Gut Microbiota Diversity and Metabolic Syndrome
|
N/A | |
Completed |
NCT03627104 -
Effect of Dietary Protein and Energy Restriction in the Improvement of Insulin Resistance in Subjects With Obesity
|
N/A | |
Completed |
NCT05124847 -
TREating Pediatric Obesity
|
N/A | |
Active, not recruiting |
NCT03288025 -
Pulmonary Arterial Hypertension Improvement With Nutrition and Exercise (PHINE)
|
N/A | |
Completed |
NCT03809182 -
Effect of Dexmedetomidine on Postoperative Glucose and Insulin Levels.
|
Phase 4 | |
Completed |
NCT01809288 -
Identifying Risk for Diabetes and Heart Disease in Women
|
||
Completed |
NCT04642482 -
Synbiotic Therapy on Intestinal Microbiota and Insulin Resistance in Obesity
|
Phase 4 | |
Terminated |
NCT03278236 -
Does Time Restricted Feeding Improve Glycaemic Control in Overweight Men?
|
N/A | |
Not yet recruiting |
NCT06159543 -
The Effects of Fresh Mango Consumption on Cardiometabolic Outcomes in Free-living Individuals With Prediabetes
|
N/A | |
Not yet recruiting |
NCT05540249 -
Pre-operative Carbohydrates in Diabetic Patients Undergoing CABG
|
N/A | |
Withdrawn |
NCT04741204 -
Metformin Use to Reduce Disparities in Newly Diagnosed Breast Cancer
|
Phase 4 |