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Body Composition and Hormonal Status in Ataxia Telangiectasia

Primary Purpose

Ataxia Telangiectasia

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
bioelectrical impedance analysis
blood draw
Sponsored by
Johann Wolfgang Goethe University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Ataxia Telangiectasia focused on measuring dystrophy, body composition, malnutrition

Eligibility Criteria

2 Years - 45 Years (Child, Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • aim group: clinically and/or genetically diagnosed A-T
  • control group: age and sex matched healthy subjects
  • age 2-45 years
  • written informed consent

Exclusion Criteria:

  • age < 2 or > 45 years
  • other diseases with influence on the immunosystem (i.e. diabetes mellitus, malignoma, dialysis-dependent renal failure)
  • current medication with hormones

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Active Comparator

    Arm Label

    Ataxia telangiectasia

    Healthy subjects

    Arm Description

    26 patients with clinically and/or genetically diagnosed Ataxia telangiectasia will be examined with bioelectrical impedance analysis (BIA), muscle force measurement, calipometry and get a blood draw

    26 age and sex matched subjects without any chronic disease or hormone displacement will be examined with bioelectrical impedance analysis (BIA), muscle force measurement, calipometry and get a blood draw

    Outcomes

    Primary Outcome Measures

    Body mass index

    Secondary Outcome Measures

    Full Information

    First Posted
    January 19, 2015
    Last Updated
    January 22, 2015
    Sponsor
    Johann Wolfgang Goethe University Hospital
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02345200
    Brief Title
    Body Composition and Hormonal Status in Ataxia Telangiectasia
    Official Title
    Body Composition, Muscle Strength and Hormonal Status in Patients With Ataxia Telangiectasia Compared to Healthy Controls
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2015
    Overall Recruitment Status
    Completed
    Study Start Date
    April 2013 (undefined)
    Primary Completion Date
    April 2014 (Actual)
    Study Completion Date
    April 2014 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Johann Wolfgang Goethe University Hospital

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Ataxia telangiectasia (A-T) is a rare devastating human recessive disorder characterized by progressive cerebellar ataxia, immunodeficiency, chromosomal instability, and cancer susceptibility. In addition to that, a high percentage of patients show dystrophy, growth retardation and poor weight gain. Nevertheless, there are only a few studies assessing this problem. Aim of the present proposal is to investigate the exact body composition, manual muscle strength and hormonal status in patients with A-T compared to healthy controls matched for gender and age. A pelvic sonography in females was performed in order to evaluate the sexual maturity of their inner genitalia. Tanner score was determined to define the physical development. Every subject received a nutritional diary to review its calorie intake and the quality of diet. The investigators expect that the A-T cohort shows an altered body composition, impaired muscle strength, changed hormonal status concerning the sexual hormones and a delayed physical development compared to healthy controls.
    Detailed Description
    Ataxia telangiectasia (A-T) is a devastating human recessive disorder characterized by progressive cerebellar ataxia, immunodeficiency, chromosomal instability, and cancer susceptibility. In addition to that, a high percentage of patients show dystrophy, growth retardation and poor weight gain. There are only a few studies assessing this problem and the exact variations concerning body composition, muscle strength and hormonal status are widely unknown. Major factors may be responsible for altered body composition: Immunodeficiency and chronic disease are important influences on growth and physical development. The constantly catabolic situation of A-T patients has a major impact on dystrophy. Due to the progressive cerebellar ataxia most of the patients are bound to wheelchair so that their muscle mass is decreased Impaired muscle strength is related to apraxia, dystonia, contractures and dyskinesia. Low levels of growth hormones (GH). Extracerebellar MRI - lesions in A-T go along with deficiency of the GH axis thus causing nanism. Delayed puberty and physical development suggest an abnormal metabolism in muscle cells There are autopsy reports informing about reduced mass of the adrenal cortex that may be reflected in a lower hormone release of steroid hormones. The aim of the proposal is to explore the exact body composition, the manual muscle strength, the hormonal status in patients with A-T compared to healthy subjects matched for sex and age. One study visit is performed in all A-T patients and healthy subjects: To evaluate weight and length of all subjects To analyze the exact structure of single body compartments such as the lean mass, the water compartment or the fat compartment using bioelectrical impedance analysis To determine the subcutaneous fat fold thickness using calipometry To investigate the nourishment habits and diet detected by nutritional diary To analyze the manual muscle strength with a hand dynamometer To determine the physical development in the A-T cohort by Tanner scores To evaluate stage of sexual development and puberty in female A-T patients by ultrasonic of the inner genitalia To get a detailed hormonal status including thyroid-stimulating hormone (TSH), luteinizing hormone (LH), follicle stimulating hormone (FSH), GH, cortisol, DHEAS, estradiol, testosterone, progesterone, insulin like growth factor-binding protein 3 (IGF-BP3), etc in serum blood

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Ataxia Telangiectasia
    Keywords
    dystrophy, body composition, malnutrition

    7. Study Design

    Primary Purpose
    Supportive Care
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    52 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Ataxia telangiectasia
    Arm Type
    Active Comparator
    Arm Description
    26 patients with clinically and/or genetically diagnosed Ataxia telangiectasia will be examined with bioelectrical impedance analysis (BIA), muscle force measurement, calipometry and get a blood draw
    Arm Title
    Healthy subjects
    Arm Type
    Active Comparator
    Arm Description
    26 age and sex matched subjects without any chronic disease or hormone displacement will be examined with bioelectrical impedance analysis (BIA), muscle force measurement, calipometry and get a blood draw
    Intervention Type
    Procedure
    Intervention Name(s)
    bioelectrical impedance analysis
    Intervention Description
    electrophysical measurement that allows to determine the exact composition of single body compartments by producing a magnetic field and detecting the potential difference through the body
    Intervention Type
    Procedure
    Intervention Name(s)
    blood draw
    Intervention Description
    blood samples are taken at 8 am in order to pay attention to the circadian rhythmicity to get a detailed hormonal status
    Primary Outcome Measure Information:
    Title
    Body mass index
    Time Frame
    12 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    2 Years
    Maximum Age & Unit of Time
    45 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: aim group: clinically and/or genetically diagnosed A-T control group: age and sex matched healthy subjects age 2-45 years written informed consent Exclusion Criteria: age < 2 or > 45 years other diseases with influence on the immunosystem (i.e. diabetes mellitus, malignoma, dialysis-dependent renal failure) current medication with hormones
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Stefan Zielen, Prof. Dr.
    Organizational Affiliation
    University Childrens´ Hospital Frankfurt
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    14229760
    Citation
    DUNN HG, MEUWISSEN H, LIVINGSTONE CS, PUMP KK. ATAXIA-TELANGIECTASIA. Can Med Assoc J. 1964 Nov 21;91(21):1106-18.
    Results Reference
    background
    PubMed Identifier
    15932513
    Citation
    Schubert R, Reichenbach J, Zielen S. Growth factor deficiency in patients with ataxia telangiectasia. Clin Exp Immunol. 2005 Jun;140(3):517-9. doi: 10.1111/j.1365-2249.2005.02782.x.
    Results Reference
    background
    PubMed Identifier
    25060036
    Citation
    Voss S, Pietzner J, Hoche F, Taylor AM, Last JI, Schubert R, Zielen S. Growth retardation and growth hormone deficiency in patients with Ataxia telangiectasia. Growth Factors. 2014 Jun;32(3-4):123-9. doi: 10.3109/08977194.2014.939805.
    Results Reference
    background
    PubMed Identifier
    19898915
    Citation
    Kieslich M, Hoche F, Reichenbach J, Weidauer S, Porto L, Vlaho S, Schubert R, Zielen S. Extracerebellar MRI-lesions in ataxia telangiectasia go along with deficiency of the GH/IGF-1 axis, markedly reduced body weight, high ataxia scores and advanced age. Cerebellum. 2010 Jun;9(2):190-7. doi: 10.1007/s12311-009-0138-0.
    Results Reference
    background
    PubMed Identifier
    21157431
    Citation
    Cosentino C, Grieco D, Costanzo V. ATM activates the pentose phosphate pathway promoting anti-oxidant defence and DNA repair. EMBO J. 2011 Feb 2;30(3):546-55. doi: 10.1038/emboj.2010.330. Epub 2010 Dec 14.
    Results Reference
    background
    PubMed Identifier
    21720878
    Citation
    Baldin AD, Fabbri T, Siviero-Miachon AA, Spinola-Castro AM, de Lemos-Marini SH, Baptista MT, D'Souza-Li LF, Maciel-Guerra AT, Guerra-Junior G. Growth hormone effect on body composition in Turner syndrome. Endocrine. 2011 Dec;40(3):486-91. doi: 10.1007/s12020-011-9504-z. Epub 2011 Jul 1.
    Results Reference
    background
    PubMed Identifier
    23055520
    Citation
    Menotta M, Biagiotti S, Bianchi M, Chessa L, Magnani M. Dexamethasone partially rescues ataxia telangiectasia-mutated (ATM) deficiency in ataxia telangiectasia by promoting a shortened protein variant retaining kinase activity. J Biol Chem. 2012 Nov 30;287(49):41352-63. doi: 10.1074/jbc.M112.344473. Epub 2012 Oct 10.
    Results Reference
    background
    PubMed Identifier
    26645295
    Citation
    Pommerening H, van Dullemen S, Kieslich M, Schubert R, Zielen S, Voss S. Body composition, muscle strength and hormonal status in patients with ataxia telangiectasia: a cohort study. Orphanet J Rare Dis. 2015 Dec 9;10:155. doi: 10.1186/s13023-015-0373-z.
    Results Reference
    derived

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    Body Composition and Hormonal Status in Ataxia Telangiectasia

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