Adiponectin Polymorphisms, Insulin Resistance, and Pharmacokinetics in Obesity

This study is currently recruiting participants. (see Contacts and Locations)
Verified May 2014 by Stanford University
Information provided by (Responsible Party):
Jerry Ingrande, Stanford University Identifier:
First received: April 30, 2012
Last updated: May 12, 2014
Last verified: May 2014

The primary objective of this study is to determine the influence of insulin resistance on drug metabolism and response in obese subjects. The investigators hypothesize that expression of adiponectin (a hormone secreted by fat tissue), and specific variants in the adiponectin gene can predict the insulin resistance and drug response among obese subjects.

Condition Intervention
Drug: Propofol, Fentanyl

Study Type: Interventional
Study Design: Endpoint Classification: Pharmacokinetics/Dynamics Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Diagnostic
Official Title: Adiponectin Polymorphisms, Insulin Resistance, and Pharmacokinetics in Obesity

Resource links provided by NLM:

Further study details as provided by Stanford University:

Primary Outcome Measures:
  • plasma concentration of drugs fentanyl and propofol [ Time Frame: measured for 12 hours (beginning of anesthesia to 12 hours after) ] [ Designated as safety issue: Yes ]

    Plasma concentration over time will be measured and modeled in order to calculate drug clearance, volume of distribution, area under the curve, and micro rate constants.

    Knowledge of these variables will allow safer administration of anesthetic drug administration in the obese population.

  • time to loss of consciousness [ Time Frame: measured once per study (at the time of induction of anesthesia) ] [ Designated as safety issue: Yes ]
    The time from propofol and fentanyl administration (time 0) until loss of consciousness will be measured in order to measure a component of drug response.

  • partial pressure of carbon dioxide in blood [ Time Frame: measured once immediately before the operation and approximately every 30 minutes for 3 hours after the operation ] [ Designated as safety issue: Yes ]
    The investigators will measure arterial blood gases to obtain blood carbon dioxide partial pressures as a measure of respiratory depression caused by fentanyl.

Secondary Outcome Measures:
  • Adiponectin plasma protein levels [ Time Frame: measured once (immediately before the operation) ] [ Designated as safety issue: No ]
    The investigators will measure specific levels of the protein adiponectin in the blood, to determine if quantitative expression of adiponectin can predict insulin resistance in obesity and drug metabolism and response.

  • Adiponectin gene polymorphisms [ Time Frame: measured once per study (immediately before the operation) ] [ Designated as safety issue: No ]
    The investigators will look at specific genetic variants of the adiponectin gene to determine if expression of specific variants can predict insulin resistance and changed in drug response and metabolism.

Estimated Enrollment: 200
Study Start Date: November 2011
Estimated Study Completion Date: September 2016
Estimated Primary Completion Date: September 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Propofol and Fentanyl administration
Propofol and Fentanyl will be administered to each subject. Each subject will have blood drawn to determine pharmacokinetic variables. Processed EEG will be used to determine pharmacodynamics. Plasma samples will be used to ascertain adiponectin levels and for DNA sampling for analysis of adiponectin single nucleotide polymorphisms.
Drug: Propofol, Fentanyl
Propofol will be administered to all patients via infusion at a dose of 2 mg/kg lean body weight/minute. The infusion will stop once loss of consciousness is reached. Fentanyl will be administered via target controlled infusion to achieve a plasma concentration of 2 ng/ml.


Ages Eligible for Study:   18 Years to 70 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Inclusion criteria include patients of adult age
  • American Society of Anesthesiologists Class I, II, or III, and undergoing elective surgical procedures requiring general anesthesia
  • Body mass index greater than 35

Exclusion Criteria:

  • Patients with evidence of hepatic, renal, or cardiovascular dysfunction
  • History of difficult tracheal intubation, or adverse reaction to anesthesia shall be excluded from the study
  • Patients taking prescribed or over-the-counter anxiolytics, narcotics, or sleeping aids, will also be excluded
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01593397

Contact: Jerry Ingrande, M.D., M.S. 650-723-7377

United States, California
Stanford University School of Medicine, Department of Anesthesia Recruiting
Stanford, California, United States, 94305
Contact: Jerry Ingrande, M.D., M.S.    650-723-7377   
Sponsors and Collaborators
Stanford University
  More Information

No publications provided

Responsible Party: Jerry Ingrande, Instructor, Stanford University Identifier: NCT01593397     History of Changes
Other Study ID Numbers: 1K23GM100273-01
Study First Received: April 30, 2012
Last Updated: May 12, 2014
Health Authority: United States: Institutional Review Board

Keywords provided by Stanford University:
Insulin Resistance

Additional relevant MeSH terms:
Insulin Resistance
Body Weight
Glucose Metabolism Disorders
Metabolic Diseases
Nutrition Disorders
Signs and Symptoms
Adjuvants, Anesthesia
Analgesics, Opioid
Anesthetics, General
Anesthetics, Intravenous
Central Nervous System Agents
Central Nervous System Depressants
Hypnotics and Sedatives
Hypoglycemic Agents
Peripheral Nervous System Agents
Pharmacologic Actions
Physiological Effects of Drugs
Sensory System Agents
Therapeutic Uses processed this record on October 30, 2014