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Trial record 3 of 8 for:    insulin resistance | leukemia

The Metabolic Syndrome Among Leukemia Survivors: Physiopathological Analysis (LEAMS)

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ClinicalTrials.gov Identifier: NCT02696304
Recruitment Status : Unknown
Verified December 2015 by Assistance Publique Hopitaux De Marseille.
Recruitment status was:  Recruiting
First Posted : March 2, 2016
Last Update Posted : March 2, 2016
Sponsor:
Information provided by (Responsible Party):
Assistance Publique Hopitaux De Marseille

Brief Summary:

Along with the improvement of childhood acute leukemia treatment, survival rates have increased. Therefore, the number of long term childhood leukemia survivors has increased progressively over the last decades. So, the assessment of long term health status in this population becomes very important. Many studies have shown an increased risk of life threatening late complications and early mortality. Cardiovascular morbidity and mortality are particularly frequent. Among these late complications, the metabolic syndrome (MS) is an important concern since it is associated with cardiovascular morbidity and mortality. The overall MS prevalence in the French prospective cohort of survivors of childhood acute leukemia was 9.2% and 18.6% in cases of total body irradiation (TBI) during the leukemia treatment. Since the median age at MS evaluation was 21 years, this prevalence was very high. Anyway, the MS pathophysiology in this population is still poorly understood. One of the most recent hypothesis about the MS mechanism is based on the adipose tissue inability to store fatty acids: when adipose tissue cannot expanse further to store excess nutriments then lipids accumulate in other tissues. This ectopic lipids accumulation can cause insulin resistance and MS.

The investigators hypothesized that the adipose tissue could be damaged by treatments received during childhood acute leukemia treatment (particularly TBI). This leads to morphological and functional abnormalities that could promote the insulin resistance and MS.

This ectopic adipose tissue contains less preadipocytes, which could impair its functional properties.

The primary endpoint of this study is to compare the morphological and functional characteristics of adipose tissue in patients with a MS who received or not TBI during childhood leukemia treatment . This comparison will focus on:

  • The adipose tissue repartition and evaluation of the ectopic adipose tissue
  • Fibrosis and inflammation of the adipose tissue
  • Preadipocytes quantification

The secondary endpoint is to describe:

  • for the whole cohort of included patients,
  • the clinical and biological characteristics associated with the MS.
  • Cardiovascular risk factors and nutritional statement
  • Anthropometric measurements
  • Detection of other endocrinal abnormalities possibly associated with the MS
  • Analysis of inflammation blood markers and adipokines quantification.

Condition or disease Intervention/treatment Phase
Metabolic Syndrome X Other: Adipose tissu repartition Other: Visceral and liver adipose tissue repartition Other: Preadipocyte quantification and adipose tissue inflamation Other: Inflamation blood markers quantification Not Applicable

Detailed Description:

Enroled patients (both groups) will be evaluated for the following criteria. Then, a comparison between both groups will be performed.

1. Primary endpoint: the following factors will be studied, and compared between both groups (with or without TBI):

  • Adipose tissue repartition using biphotonic absorptiometry and abdominal MRI
  • Ectopic adipose tissue evaluation (visceral and hepatical) using MRI and proton spectroscopy
  • Adipose tissue inflammation (using PCR array) : quantification of the following biomarkers: alpha TNF, IL6, IL1beta, IL10, MCP1, leptine and adiponectine
  • Adipose tissue fibrosis (PCR array): quantification of the following markers of fibrosis: Col 1a1, Col 3a1, Col 6a1, Col 6a3, Tenascin C, Lumican, TGF beta
  • Preadipocytes quantification in the adipose tissue (immunohistochemistery)

Concerning the secondary endpoints, the following points will be studied :

  • Cardiovascular risk factors and nutritional statement
  • Anthropometric measurements
  • Other endocrinal abnormalities possibly associated with the MS
  • Analysis of inflammation blood markers and adipokines quantification.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 30 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: The Metabolic Syndrome Among Childhood Acute Leukemia Survivors: Physiopathological Analysis
Study Start Date : May 2015
Estimated Primary Completion Date : May 2016
Estimated Study Completion Date : December 2016

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
TBI for childhood leukemia
Patients with a metabolic syndrom who received TBI.
Other: Adipose tissu repartition
absorptiometry,

Other: Visceral and liver adipose tissue repartition
MRI,spectroscopy,

Other: Preadipocyte quantification and adipose tissue inflamation
biopsy

Other: Inflamation blood markers quantification
blood drawn,

No TBI for childhood leukemia
Patients with a metabolic syndrom without previousTBI
Other: Adipose tissu repartition
absorptiometry,

Other: Visceral and liver adipose tissue repartition
MRI,spectroscopy,

Other: Preadipocyte quantification and adipose tissue inflamation
biopsy

Other: Inflamation blood markers quantification
blood drawn,




Primary Outcome Measures :
  1. Percent of fat mass (Biphotonic absorptiometry) [ Time Frame: 1 year ]
  2. Evaluation of the amount of intra liver and pancreatic triglycerides (%) (proton spectroscopy, expressed as percent related to liver or pancreatic water content) [ Time Frame: 1 year ]
  3. Fibrosis and inflammation analyses of the adipose tissu : fibrosis and inflammation gene expression analyses by RQ-PCR [ Time Frame: 1 year ]
  4. Preadipocytes quantification in the adipose tissue by immunohistochemistery, expressed as percent of stroma vascular fraction of the adipose tissue [ Time Frame: 1 year ]


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age superior or equal to 18 years
  • Metabolic syndrome: at least 3 criteria among the following:

    1. Waist circumference ≥ 102 cm for male and ≥ 88 cm for female)
    2. High triglyceride level ≥ 150 mg/dl (1,7 mmol/l) or undergoing treatment for that affection
    3. Low HDL-Cholesterol < 40 mg/dl (1,03 mmol/l) for male ; < 50 mg/dl (1,3 mmol/l) for femal, or undergoing treatment for that affection
    4. Elevated blood pressure: systolic ≥ 130 mmHg and/or diastoloic ≥ 85 mmHg or undergoing treatment for that affection
    5. Elevated fasten glucose≥ 100 mg/dl or undergoing treatment for that affection
  • Acute leukemia during childhood (under 18 years of age at the time of leukemia diagnosis)
  • Informed consent obtained

Exclusion Criteria:

  • pregnancy
  • incomplete evaluation of metabolic syndrome

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02696304


Contacts
Contact: Claire OUDIN, MD claire.oudin@ap-hm.fr

Locations
France
Assistance Publique Hopitaux de Marseille Recruiting
Marseille, France, 13354
Contact: Claire Oudin       claire.oudin@ap-hm.fr   
Principal Investigator: Claire Oudin, MD         
Sponsors and Collaborators
Assistance Publique Hopitaux De Marseille
Investigators
Study Director: Urielle DESALBRES AP-HM
Principal Investigator: Claire OUDIN, MD AP-HM

Responsible Party: Assistance Publique Hopitaux De Marseille
ClinicalTrials.gov Identifier: NCT02696304     History of Changes
Other Study ID Numbers: 2015-A00170-49
2015-05 ( Other Identifier: APHM )
First Posted: March 2, 2016    Key Record Dates
Last Update Posted: March 2, 2016
Last Verified: December 2015

Additional relevant MeSH terms:
Syndrome
Metabolic Syndrome X
Disease
Pathologic Processes
Insulin Resistance
Hyperinsulinism
Glucose Metabolism Disorders
Metabolic Diseases