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Understanding the Roles of Hormones in Adipocyte Remodeling Following Menopause (RESUME-2)

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ClinicalTrials.gov Identifier: NCT03856268
Recruitment Status : Recruiting
First Posted : February 27, 2019
Last Update Posted : September 10, 2019
Sponsor:
Collaborators:
University of Colorado, Denver
University of Alabama at Birmingham
Information provided by (Responsible Party):
Kara Marlatt, Pennington Biomedical Research Center

Brief Summary:

The overarching aims of this study are to:

  1. Characterize the rate of in vivo adipogenesis, and changes in adipose tissue gene and protein expression, in the scABD and scFEM depots of women undergoing surgical menopause (↓E2, ↑FSH).
  2. Characterize the rate of in vivo adipogenesis, and changes in adipose tissue gene and protein expression, in the scABD and scFEM depots of women undergoing gonadal suppression (↓E2, ↓FSH).

Condition or disease Intervention/treatment
Menopause Surgical Estrogen Deficiency Adiposity Follicle-Stimulating Hormone Deficiency Hormone Deficiency Procedure: 'Surgical Menopause' Group Drug: 'Drug-Induced Menopause' Group

Detailed Description:

This is a cross-sectional study where two groups of premenopausal women (ages 18-50 y) will be enrolled in a parallel arm study:

  • Arm 1 (Surgical Menopause): up to 6 women undergoing laparoscopic, elective bilateral oophorectomy [Site: Pennington Biomedical Research Center].
  • Arm 2 (Pharmacology-Induced Menopause): up to 6 women undergoing gonadal suppression via leuprolide acetate (Lupron [AbbVie Inc.]) [Site: UC-Denver].

We will compare each arm of women to non-oophorectomized, premenopausal women (controls) with normal menstrual cycles (Apple&Pear study; NCT01748994; PI: Ravussin) selectively matched (1:2) for age and BMI. The Apple&Pear study uses the same in vivo adipogenesis labeling protocol, with similar age and BMI criteria, as the proposed study.


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Study Type : Observational
Estimated Enrollment : 12 participants
Observational Model: Cohort
Time Perspective: Cross-Sectional
Official Title: Understanding the Roles of Estradiol and Follicle-stimulating Hormone in Adipocyte Remodeling Following Surgical and Pharmacology-induced Menopause (RESUME-2 Study)
Actual Study Start Date : April 1, 2019
Estimated Primary Completion Date : March 31, 2020
Estimated Study Completion Date : March 31, 2021

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Hormones Menopause

Group/Cohort Intervention/treatment
ARM 1: 'Surgical Menopause' Group
Premenopausal women having an oophorectomy.
Procedure: 'Surgical Menopause' Group
Women undergoing laparoscopic oophorectomy surgery ('surgical menopause') will be enrolled at Pennington Biomedical.
Other Name: 'Bilateral Oophorectomy Surgery' Group

ARM 2: "Drug-Induced Menopause'
Premenopausal women with gonadal suppression
Drug: 'Drug-Induced Menopause' Group
Women undergoing gonadal suppression via leuprolide acetate (Lupron [AbbVie Inc.]) will be enrolled at the University of Colorado-Denver.
Other Name: 'Pharmacology-Induced Menopause' Group

'Comparative (Control)' Group
Premenopausal women with regular cycles.



Primary Outcome Measures :
  1. Rate of in vivo adipogenesis (via deuterium-enrichment of adipose tissue DNA) [ Time Frame: Change from baseline in enrichment of DNA of adipose cells with deuterium at 8 weeks ]
    Deuterium from the deuterium-labeled water is incorporated into the newly-synthesized DNA of newly-formed fat cell precursor cells through cell replication. The latter carry over the label when they become fat cells through differentiation. Enzymatic digestion of the fat tissue isolates the individual cells constituting the fat tissue. Centrifugation of the cell suspension allows the separation of fat cells into a floating layer and a pellet comprised of stromal-vascular cells including the fat cell precursor cells and small fat cells. As the fat cell precursor cells and small adipocytes have the property to attach quickly to plastic surfaces of culture dishes, a brief culturing of the stromal-vascular cells sorts these cells from the remaining cells. Thus, measuring the deuterium-enrichment of DNA from plastic-adherent stromal-vascular cells indicates the rate of in vivo formation of new mature fat cells and pre-adipocytes, a process collectively termed adipogenesis.


Secondary Outcome Measures :
  1. Size of adipocytes [ Time Frame: Change from baseline in size of adipocytes at 8 weeks post-surgery ]
    Fat cell size will be determined using osmium fixation of the lipids and measurement of their diameter with Coulter Counter followed by calculation of fat cell volume. The mean lipid content of fat cells will be calculated by multiplying the fat cell volume by the density of triolein (0.915).

  2. Number of adipocytes [ Time Frame: Change from baseline in number of adipocytes at 8 weeks post-surgery ]
    Fat cell number will be estimated by dividing the volume of adipose tissue depot of interest to the mean fat cell volume or the fat mass of the depot to the mean lipid content in fat cell.

  3. Body composition (by Dual-energy X-ray Absorptiometry (DXA)) [ Time Frame: Change from baseline in body composition at 8 weeks post-surgery ]
    Fat mass, fat-free mass, and percent body fat will be assessed using a whole-body scanner GE iDXA.

  4. Adipose tissue gene and protein expression [ Time Frame: Changes from baseline in gene and protein expression at 8 weeks post-surgery ]
    Expression levels of genes and proteins involved in adipocyte expansion and function (ERα, PPARγ2, C/EBPα, aromatase, adiponectin, and LPL), extracellular matrix remodeling and fibrosis (COL6(a1, a2, a3), COL4a1, and TGFβ), and inflammation (IL-6 and TNFα) will be assessed.


Biospecimen Retention:   Samples With DNA
Adipose tissue


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 50 Years   (Adult)
Sexes Eligible for Study:   Female
Gender Based Eligibility:   Yes
Gender Eligibility Description:   Premenopausal women planning to undergo elective, laparoscopic bilateral oophorectomy surgery OR gonadal suppression via leuprolide acetate (Lupron [AbbVie Inc.]).
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
Women (aged 18-50 y) will be enrolled. Women will be pre-menopausal, not pregnant, and not using hormone therapy or have medical indication for increased cancer risk.
Criteria

INCLUSION CRITERIA:

  • Healthy female
  • Ages 18-50 y
  • Planning to have either a laparoscopic bilateral oophorectomy or a laparoscopic unilateral oophorectomy (which would result in no remaining ovaries)
  • Are willing to drink heavy water (2H2O) over an 8-week period
  • Medically cleared for participation in the study by OB/GYN and Medical Investigator
  • Are willing to have blood and fat tissue stored for future use

EXCLUSION CRITERIA:

  • Meet either of the following criteria:
  • Have all 3 of the major menopause-related symptoms [hot flashes, mood swings, insomnia (trouble sleeping)]
  • Have 2 of the major menopause-related symptom combinations [hot flashes and mood swings, or hot flashes and insomnia (trouble sleeping)]
  • Unstable weight in the last 3 months [gain or loss >7 lb (or 3.2 kg)]
  • History of clinically diagnosed diabetes or a fasting blood glucose >126 mg/dL
  • Chronic use of systemic glucocorticoids, antipsychotic/antidepressant medications, thiazolidinediones and other medications that cause clinically significant weight gain, weight loss or are known to make changes in fat cell number/size *
  • Previous bariatric surgery (or other surgeries) for obesity or weight loss (< 3 years ago)
  • Use of over the counter or prescription weight loss products
  • History of metabolic diseases (other than diabetes)
  • History of neurological disease
  • History of cardiovascular disease (or other chronic diseases)
  • Pregnant, planning to become pregnant, or breastfeeding
  • Use of hormone replacement therapy
  • Unwilling to discontinue any form or hormonal therapy (e.g., contraceptives including birth control pills, vaginal ring, injections, implant, or skin patch; hormonal supplements, etc.) upon enrollment (after the Screening Visit).

    • Inconsistent use of medications listed above will be evaluated and left up to the discretion of the Medical Investigator to evaluate safety.

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): NCT03856268


Contacts
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Contact: Kara L Marlatt, PhD, MPH 225-763-2871 kara.marlatt@pbrc.edu
Contact: Leanne M Redman, PhD 225-763-0947 leanne.redman@pbrc.edu

Locations
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United States, Louisiana
Pennington Biomedical Research Center Recruiting
Baton Rouge, Louisiana, United States, 70808
Contact: Kara L Marlatt, PhD, MPH    225-763-2871    kara.marlatt@pbrc.edu   
Sponsors and Collaborators
Pennington Biomedical Research Center
University of Colorado, Denver
University of Alabama at Birmingham
Investigators
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Principal Investigator: Kara L Marlatt, PhD, MPH Pennington Biomedical Research Center

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Responsible Party: Kara Marlatt, Postdoctoral Researcher - John S McIlhenny Skeletal Muscle Physiology - Ravussin, Pennington Biomedical Research Center
ClinicalTrials.gov Identifier: NCT03856268     History of Changes
Other Study ID Numbers: PBRC 2019-TBD
First Posted: February 27, 2019    Key Record Dates
Last Update Posted: September 10, 2019
Last Verified: September 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided
Plan Description: Data will be made available upon request.

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Endocrine System Diseases
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs