Low Dose Growth Hormone Treatment in Subjects With Metabolic Syndrome.
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Purpose
Study hypothesis:
Low dose growth hormone (GH), through its generation of free 'bioavailable' insulin-like growth factor (IGF)-I, can improve insulin sensitivity and the metabolic profile of subjects with metabolic syndrome.
Study aims:
The purpose of this study is to determine the mechanism of how low dose GH treatment affects the body's sensitivity to insulin actions and whether this low GH dose can affect the body's handling of steroid hormone levels (cortisol clearance) and fat deposition in subjects with metabolic syndrome.
Study design: Subjects that satisfy the criteria of metabolic syndrome (central obesity, treated or untreated high blood pressure, high cholesterol and impaired fasting glucose levels) will be invited to participate in this study. The subjects will be assessed at the initial visit to ascertain their suitability before further participation in the study. If eligible, an equal number of men and women will be randomized (like a flip of a coin) to receive either daily low dose GH or placebo injections first for 12 weeks, before exchanging over for another 12 weeks of treatment after a 4-week washout period. Before, during and after treatment, the subjects will be assessed at frequently with blood tests, scans and fat biopsies. During the study, the subjects will be studied 4 times at the Oregon Clinical and Translational Research Institute (OCTRI). At the first, second and final visit, testing will include scans to measure the amount of whole body fat and fat in the stomach area, muscle, and liver; blood tests to measure levels of cortisol, and fat tissue (taken from a biopsy) analysis to measure the density of insulin-like growth factor-I (a hormone stimulated by growth hormone in the body) in fat; whereas blood tests to examine how well insulin works in the body (insulin sensitivity) will be collected at all visits of the study.
| Condition | Intervention |
|---|---|
|
Metabolic Syndrome |
Drug: Norditropin |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Effects of a Fixed Low Dose Growth Hormone Therapy on Insulin Sensitivity, Metabolic Profile, Adipocyte IGF-I and Insulin Signalling, Intramyocellular and Intrahepatic Lipids, and Cortisol Metabolism in Subjects With Metabolic Syndrome. |
- Changes in insulin sensitivity, and adipocyte IGF-I and insulin receptor signaling. [ Time Frame: 24 months ] [ Designated as safety issue: Yes ]
- Changes in body composition, cortisol production rates, and muscle and liver intramyocellular content. [ Time Frame: 24 months ] [ Designated as safety issue: Yes ]
| Enrollment: | 0 |
| Study Start Date: | October 2010 |
| Estimated Study Completion Date: | December 2012 |
| Estimated Primary Completion Date: | October 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
Growth hormone or Placebo 0.1 mg/day self-administrated once a day.
|
Drug: Norditropin
Norditropin 0.1 mg/day self-administered once a day subcutaneously
Other Name: Growth hormone, metabolic syndrome, insulin sensitivity
|
Show Detailed Description Eligibility| Ages Eligible for Study: | 21 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Ability to provide written informed consent and comply with study assessments for the full duration of the study.
- Age 21 to 65 years
- Body mass index between 25 to 40 kg/m2
- Diagnosis of MBS based on the consensus statement by the International Diabetes Federation i.e., central obesity defined by waist circumference in men of ≥ 94 cm and in women of ≥ 80 cm plus two other components from the following: 1) dyslipidemia (triglyceride levels ≥ 150 mg/dl or on therapy and/or HDL in men of < 40 mg/dl and in women of < 50 mg/dl or on therapy); 2) hypertension (blood pressure ≥ 130/85 mmHg or on therapy and 3) hyperglycemia (fasting plasma glucose ≥ 100 mg/dl or on therapy)
- Stable weight and diet for at least 6 months prior to study entry
- Normal thyroid function
- Normal renal and hepatic function
- Able to self administer GH/Placebo injections
Exclusion Criteria:
- Inability to comply with study requirements
- Body mass index < 30 kg/m2 and > 40 kg/m2 (patients with body mass index > 40 kg/m2 are excluded because they will not fit into the MRS scanner)
- Untreated hypothyroidism or hyperthyroidism
- Anemia from any cause
- Known diabetes mellitus
- Patients with an increased risk of venous thrombosis or previous history of recurrent venous thrombosis
- Patient on any insulin-sensitizers (e.g., Metformin, Rosiglitazone, Pioglitazone) within 30 days of screening assessment
- Patient on any anti-androgens (e.g., Spironolactone, Cyproterone acetate, Flutamide, Finasteride) within 30 days of screening assessment
- Patient with other concurrent illnesses
- Pregnant (positive pregnancy test) prior enrollment in the study or planning to conceive whilst participating in the study
- Emotional/social instability likely to prejudice study completion
- Previous history of known malignancy
- Recurrent or severe unexplained hypoglycemia
- Known or suspected drug/alcohol abuse
- Patient with any metals in the body
- Any other condition/s that the investigator believes would pose a significant hazard to the subject if the investigational therapy were initiated
- Participation in another simultaneous medical investigation or trial
Contacts and Locations| United States, Oregon | |
| Oregon Health and Science University | |
| Portland, Oregon, United States, 97239 | |
| Principal Investigator: | Kevin C. Yuen, MRCP(UK), MD | Oregon Health and Science University |
More Information
Additional Information:
Publications:
| Responsible Party: | Kevin Yuen, Associate Professor of Endocrinology, Oregon Health and Science University |
| ClinicalTrials.gov Identifier: | NCT00720616 History of Changes |
| Other Study ID Numbers: | IRB4481 |
| Study First Received: | July 21, 2008 |
| Last Updated: | February 18, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Oregon Health and Science University:
|
Growth hormone Metabolic syndrome Insulin sensitivity |
Additional relevant MeSH terms:
|
Metabolic Syndrome X Insulin Resistance Hyperinsulinism Glucose Metabolism Disorders Metabolic Diseases Hormones |
Insulin Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Pharmacologic Actions Hypoglycemic Agents |
ClinicalTrials.gov processed this record on May 19, 2013