search
Back to results

Insulin Resistance in Smokers Undergoing Smoking Cessation

Primary Purpose

Cardiovascular Disease, Insulin Resistance

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Smoking cessation
Sponsored by
Charles Drew University of Medicine and Science
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Cardiovascular Disease focused on measuring Smoking, Insulin resistance, Metabolic syndrome, Body fat distribution, Cigarette smoking

Eligibility Criteria

25 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age 25 to 70 inclusive; any ethnicity
  • Cigarette smoking for at least 3 years, at a rate of at least 1 but not more than 2 packs per day
  • BMI 19 kg/m2 or greater and 40 kg/m2 or less
  • Willing to enter, and be able to comply with the instructions and scheduled follow-up of a smoking cessation program

Exclusion Criteria:

  • Any physical disabilities that prevent the subject from participating in the study, as determined by the investigators
  • History of CVD (ventricular arrhythmias, atrial arrhythmias with a history of hemodynamic instability, unstable angina, myocardial infarction, invasive coronary revascularization, or any hospitalization for CVD within the last 3 years, NYHA Class III or IV CHF)
  • Current abuse of illicit drugs or heavy ethanol use
  • History or baseline laboratory evidence of diabetes mellitus
  • History of chronic obstructive pulmonary disease (COPD)
  • BMI < 19 or > 40 kg/m2
  • Subjects not following a regular diet and lifestyle pattern (e.g, homeless)
  • Uncontrolled hypertension (BP 170 mmHg or greater systolic or 110 mmHg or greater diastolic)
  • Fasting triglycerides 700 mg/dL or greater, or LDL-cholesterol 200 mg/dL or greater
  • History of chronic renal or liver disease (hepatic transaminase elevations > 3 times the upper limit of the normal range; creatinine > 1.5 mg/L), malignancies not currently in remission, gastrointestinal disorders that interfere with nutrition; history of malnutrition, chronic infections (including HIV), or recent (within 30 days) surgeries or hospitalizations
  • Concurrent use of medications that may alter metabolic parameters (including metformin, sulfonylurea agents, thiazolidinediones, weight loss agents, androgens or systemic glucocorticoids); lipid-lowering agents and oral contraceptives will be permitted as long as formulations, dosages and adherence remain unchanged throughout the course of the study. Oral contraceptives that are started during the course of the study will require the subject to be withdrawn from the study
  • Perimenopausal women experiencing irregular menses, because of changing metabolic status during the perimenopause; these patients may be included if menses have ceased for at least 6 months
  • Women who are pregnant, seeking to become pregnant in the next 6 months, or who are breastfeeding
  • Any history of depression, suicidality, or any contraindications to bupropion (history of seizures, anorexia or bulimia)
  • Current use of nicotine replacement products (gum or patch)
  • Any other factors that, in the opinion of the investigators, may interfere with the safe conduct, successful completion, or data integrity of the study

Sites / Locations

  • Charles Drew University of Medicine and Science

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Smokers

Arm Description

Cigarette smokers wishing to quit

Outcomes

Primary Outcome Measures

Insulin sensitivity by euglycemic hyperinsulinemic clamp

Secondary Outcome Measures

Body mass index
Body composition
Body fat distribution
Blood pressure
Fasting lipid profile
Apolipoproteins
Fasting plasma glucose
HOMA-IR index
Adipokines
Highly-sensitive C-reactive protein
Morning cortisol
IGF-1
Mean total daily caloric intake
Mean total daily caloric expenditure
Suppression of hepatic glucose production by clamp
Resting energy expenditure by calorimetry
Oxidative and non-oxidative glucose disposal by clamp
Total energy expenditure under hyperinsulinemia by clamp
Fat oxidation under hyperinsulinemia by clamp
Fatty acid suppression under hyperinsulinemia by clamp
Adverse events

Full Information

First Posted
February 23, 2009
Last Updated
February 7, 2014
Sponsor
Charles Drew University of Medicine and Science
search

1. Study Identification

Unique Protocol Identification Number
NCT00877513
Brief Title
Insulin Resistance in Smokers Undergoing Smoking Cessation
Official Title
Insulin Resistance in Smokers Undergoing Smoking Cessation
Study Type
Interventional

2. Study Status

Record Verification Date
February 2014
Overall Recruitment Status
Terminated
Why Stopped
Funding expired
Study Start Date
February 2009 (undefined)
Primary Completion Date
December 2013 (Actual)
Study Completion Date
December 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Charles Drew University of Medicine and Science

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Cigarette smoking increases CVD risk and worsens insulin resistance, but also contributes to weight loss; smoking cessation reduces CVD risk and improves insulin sensitivity, but also contributes to weight gain. The mechanisms that underlie these metabolic changes of cigarette smoking and smoking cessation on insulin resistance, body composition, and fat distribution are poorly understood.
Detailed Description
This study is a prospective, open cohort study of smokers who undergo a smoking cessation program, and who subsequently may or may not resume smoking spontaneously. Eligible subjects will be characterized at baseline with respect to their metabolic and CVD risk profiles, body fat composition and distribution. Subjects will then undergo an intensive 8-week smoking cessation program using bupropion plus cognitive behavioral counseling. Those who successfully abstain will be reassessed. Since most individuals who quit smoking will naturally resume smoking again over time, subjects will be assessed again after an additional 4 months of follow-up when a subset of subjects will be expected to have naturally resumed smoking.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cardiovascular Disease, Insulin Resistance
Keywords
Smoking, Insulin resistance, Metabolic syndrome, Body fat distribution, Cigarette smoking

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
103 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Smokers
Arm Type
Experimental
Arm Description
Cigarette smokers wishing to quit
Intervention Type
Behavioral
Intervention Name(s)
Smoking cessation
Intervention Description
Smoking cessation program over 8 weeks, consisting of cognitive behavioral counseling every 2 weeks along with adjunctive use of bupropion
Primary Outcome Measure Information:
Title
Insulin sensitivity by euglycemic hyperinsulinemic clamp
Time Frame
8 weeks, 6 months
Secondary Outcome Measure Information:
Title
Body mass index
Time Frame
8 weeks, 4 months, 6 months
Title
Body composition
Time Frame
8 weeks, 4 months, 6 months
Title
Body fat distribution
Time Frame
8 weeks, 4 months, 6 months
Title
Blood pressure
Time Frame
8 weeks, 4 months, 6 months
Title
Fasting lipid profile
Time Frame
8 weeks, 4 months, 6 months
Title
Apolipoproteins
Time Frame
8 weeks, 4 months, 6 months
Title
Fasting plasma glucose
Time Frame
8 weeks, 4 months, 6 months
Title
HOMA-IR index
Time Frame
8 weeks, 4 months, 6 months
Title
Adipokines
Time Frame
8 weeks, 4 months, 6 months
Title
Highly-sensitive C-reactive protein
Time Frame
8 weeks, 4 months, 6 months
Title
Morning cortisol
Time Frame
8 weeeks, 4 months, 6 months
Title
IGF-1
Time Frame
8 weeks, 4 months, 6 months
Title
Mean total daily caloric intake
Time Frame
8 weeks, 4 months, 6 months
Title
Mean total daily caloric expenditure
Time Frame
8 weeks, 4 months, 6 months
Title
Suppression of hepatic glucose production by clamp
Time Frame
8 weeks, 6 months
Title
Resting energy expenditure by calorimetry
Time Frame
8 weeks, 6 months
Title
Oxidative and non-oxidative glucose disposal by clamp
Time Frame
8 weeks, 6 months
Title
Total energy expenditure under hyperinsulinemia by clamp
Time Frame
8 weeks, 6 months
Title
Fat oxidation under hyperinsulinemia by clamp
Time Frame
8 weeks, 6 months
Title
Fatty acid suppression under hyperinsulinemia by clamp
Time Frame
8 weeks, 6 months
Title
Adverse events
Time Frame
8 weeks, 4 months, 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
25 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 25 to 70 inclusive; any ethnicity Cigarette smoking for at least 3 years, at a rate of at least 1 but not more than 2 packs per day BMI 19 kg/m2 or greater and 40 kg/m2 or less Willing to enter, and be able to comply with the instructions and scheduled follow-up of a smoking cessation program Exclusion Criteria: Any physical disabilities that prevent the subject from participating in the study, as determined by the investigators History of CVD (ventricular arrhythmias, atrial arrhythmias with a history of hemodynamic instability, unstable angina, myocardial infarction, invasive coronary revascularization, or any hospitalization for CVD within the last 3 years, NYHA Class III or IV CHF) Current abuse of illicit drugs or heavy ethanol use History or baseline laboratory evidence of diabetes mellitus History of chronic obstructive pulmonary disease (COPD) BMI < 19 or > 40 kg/m2 Subjects not following a regular diet and lifestyle pattern (e.g, homeless) Uncontrolled hypertension (BP 170 mmHg or greater systolic or 110 mmHg or greater diastolic) Fasting triglycerides 700 mg/dL or greater, or LDL-cholesterol 200 mg/dL or greater History of chronic renal or liver disease (hepatic transaminase elevations > 3 times the upper limit of the normal range; creatinine > 1.5 mg/L), malignancies not currently in remission, gastrointestinal disorders that interfere with nutrition; history of malnutrition, chronic infections (including HIV), or recent (within 30 days) surgeries or hospitalizations Concurrent use of medications that may alter metabolic parameters (including metformin, sulfonylurea agents, thiazolidinediones, weight loss agents, androgens or systemic glucocorticoids); lipid-lowering agents and oral contraceptives will be permitted as long as formulations, dosages and adherence remain unchanged throughout the course of the study. Oral contraceptives that are started during the course of the study will require the subject to be withdrawn from the study Perimenopausal women experiencing irregular menses, because of changing metabolic status during the perimenopause; these patients may be included if menses have ceased for at least 6 months Women who are pregnant, seeking to become pregnant in the next 6 months, or who are breastfeeding Any history of depression, suicidality, or any contraindications to bupropion (history of seizures, anorexia or bulimia) Current use of nicotine replacement products (gum or patch) Any other factors that, in the opinion of the investigators, may interfere with the safe conduct, successful completion, or data integrity of the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stanley Hsia, MD
Organizational Affiliation
Charles Drew University of Medicine and Science
Official's Role
Principal Investigator
Facility Information:
Facility Name
Charles Drew University of Medicine and Science
City
Los Angeles
State/Province
California
ZIP/Postal Code
90059
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Insulin Resistance in Smokers Undergoing Smoking Cessation

We'll reach out to this number within 24 hrs