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Link Between the Peripheral Mononuclear Cells' Capacity to Induce Insulin Resistance and Hyperinsulinemia (IRACTIV)

Primary Purpose

Insulin Resistance, Hyperinsulinism, Immune System

Status
Active
Phase
Not Applicable
Locations
France
Study Type
Interventional
Intervention
Blood test
Sponsored by
Centre Hospitalier Universitaire de Nīmes
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Insulin Resistance focused on measuring Insulin resistance

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Individuals who participated in the MetACTIV study.
  • Profile 2 subgroup-specific inclusion criteria:
  • MetACTIV study individual with a Profile 2.
  • Persons who have given free informed consent.
  • Persons who have signed the consent form.
  • Persons affiliated to or benefiting from a health insurance plan.
  • Adults (≥18 years of age).

Exclusion Criteria:

  • Persons participating in Category 1 research involving human subjects
  • Persons in an exclusion period as determined by another study.
  • Persons under court protection, guardianship or trusteeship.
  • Persons who are incapable of giving consent.
  • Persons for whom it is impossible to give clear information.
  • Pregnant, parturient or breastfeeding woman.

Sites / Locations

  • Centre Hospitalier Universitaire
  • Caisse Primaire d'Assurance Maladie du Gard

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

10 patients with high insulin levels (13.3 ± 9.2 microU/mL) and markers of metabolic syndrome

20 patients with other immune profiles

Arm Description

These are individuals who were isolated from the previous MetACTIV study due to their specific immune profile (Profile 2) defined by 43 immune activation markers and characterized by a high percentage of differentiated T cells and activated T cells.

Outcomes

Primary Outcome Measures

Fasting blood glucose
Fasting blood glucose will be measured during a routine health evaluation and measured in mM/L.
End-of-study insulinemia
The amount of insulin in the blood of patients will be measured during a routine health evaluation and measured in µU/L.
Effect of peripheral blood mononuclear cell supernatant on intensity of the signal induced by insulin in hepatocytes.
Peripheral blood mononuclear cells are isolated on a Ficoll gradient and frozen. These frozen peripheral blood mononuclear cells will be sent to the Institute of Human Genetics for culture and supernatants will be recovered after 48 hours. The effect of these supernatants on insulin signaling will then be tested. To do so, they will be added or not to cultured HepG2 cells stimulated 24 hours later by 10nM insulin. After stimulation, HepG2 cells will be lysed and their total Akt and phosphorylated Akt content measured by ELISA and Western Blot. The proportion of phosphorylated Akt in HepG2 cells exposed to peripheral blood mononuclear cells supernatant will be compared with the proportion of phosphorylated Akt in HepG2 cells not exposed to peripheral blood mononuclear cells supernatant and expressed as the percentage of insulin signaling inhibition induced by the peripheral blood mononuclear cells supernatant.

Secondary Outcome Measures

A. Percentage inhibition of Akt phosphorylation in Profile 2 patients compared with other immune profiles.
The decrease in signal intensity induced in hepatocytes by insulin induced by peripheral blood mononuclear cell supernatant from volunteers with Profile 2 will be compared to the decrease in this intensity induced by peripheral blood mononuclear cell supernatant from volunteers with another immune activation Profile. Measured as a percentage.
B. Increase in insulinemia over time in Profile 2 patients compared with other immune profiles.
Insulinemia in Profile 2 volunteers, measured in µU/mL, will be compared with that of other immune profiles.

Full Information

First Posted
April 6, 2022
Last Updated
September 5, 2023
Sponsor
Centre Hospitalier Universitaire de Nīmes
Collaborators
Caisse Primaire d'Assurance Maladie du Gard
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1. Study Identification

Unique Protocol Identification Number
NCT05329337
Brief Title
Link Between the Peripheral Mononuclear Cells' Capacity to Induce Insulin Resistance and Hyperinsulinemia
Acronym
IRACTIV
Official Title
Seeking a Link Between the Capacity of Peripheral Mononuclear Cells to Induce Insulin Resistance and the Development of Hyperinsulinemia in a General Population
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
June 27, 2022 (Actual)
Primary Completion Date
October 5, 2022 (Actual)
Study Completion Date
December 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Centre Hospitalier Universitaire de Nīmes
Collaborators
Caisse Primaire d'Assurance Maladie du Gard

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This is a two-center proof-of-concept study, ancillary to the MetACTIV study, whose objective is to define immune activation profiles from the data of individuals followed by the Caisse Primaire d'Assurance Maladie du Gard (health insurance fund). The IRACTIV study will include a subset of volunteers from the MetACTIV study for whom a blood sample will be taken as part of the IRACTIV study.
Detailed Description
The local health insurance fund regularly offers people who have already had a free health check-up the opportunity to re-do a check-up. This invitation will be made as part of the routine, by mail. People who have participated in the MetACTIV study will be asked to participate in the present IRACTIV study ( they will be sent an information note). That way, up to 30 volunteers who previously participated in the MetACTIV study, including 10 for whom a particular profile has been identified will be recruited again in sequence. On the day of consultation at the Gard health insurance fund, consent will be collected from subjects who have agreed to participate. The participation of the volunteers will be reduced to this single visit and 16 mL of blood will be collected on EDTA for the purpose of this study. As in the previous MetACTIV study, this blood will be transported to the Biological Resource Center at Nîmes University Hospital. From this blood, the plasma will be frozen and stored at -80°C for subsequent determination of insulin levels under the same conditions as for the MetACTIV study. Peripheral blood mononuclear cells will be frozen and, later, cultured at the Institute of Human Genetics in complete medium for 48 hours. The effect of the supernatants of these cultures on Akt phosphorylation in HepG2 cells exposed to 10nM of insulin will then be quantified by two different techniques (Western Blot and ELISA). This effect will be expressed as a percentage of inhibition compared to the phosphorylation of Akt induced by insulin alone. The insulin slope between the measurement performed in the MetACTIV study and this IRACTIV study will also be calculated and compared to the peripheral blood mononuclear cells ability to induce insulin resistance in vitro.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Insulin Resistance, Hyperinsulinism, Immune System
Keywords
Insulin resistance

7. Study Design

Primary Purpose
Health Services Research
Study Phase
Not Applicable
Interventional Study Model
Sequential Assignment
Model Description
This is a two-center proof-of-concept study, ancillary to the MetACTIV study, whose objective is to define immune activation profiles from the data of individuals followed by the Gard health insurance fund. The IRACTIV study will include a subset of volunteers from the MetACTIV study for whom a blood sample will be taken as part of the IRACTIV study. In order to study the evolution of insulin levels in volunteers, we need to be able to ensure a longitudinal analysis, which requires a link with the MetACTIV study data for the volunteers included in the IRACTIV study.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
10 patients with high insulin levels (13.3 ± 9.2 microU/mL) and markers of metabolic syndrome
Arm Type
Experimental
Arm Description
These are individuals who were isolated from the previous MetACTIV study due to their specific immune profile (Profile 2) defined by 43 immune activation markers and characterized by a high percentage of differentiated T cells and activated T cells.
Arm Title
20 patients with other immune profiles
Arm Type
Active Comparator
Intervention Type
Diagnostic Test
Intervention Name(s)
Blood test
Intervention Description
Sixteen mL of blood will be collected on EDTA for the purpose of this study
Primary Outcome Measure Information:
Title
Fasting blood glucose
Description
Fasting blood glucose will be measured during a routine health evaluation and measured in mM/L.
Time Frame
Day 0
Title
End-of-study insulinemia
Description
The amount of insulin in the blood of patients will be measured during a routine health evaluation and measured in µU/L.
Time Frame
Month 18
Title
Effect of peripheral blood mononuclear cell supernatant on intensity of the signal induced by insulin in hepatocytes.
Description
Peripheral blood mononuclear cells are isolated on a Ficoll gradient and frozen. These frozen peripheral blood mononuclear cells will be sent to the Institute of Human Genetics for culture and supernatants will be recovered after 48 hours. The effect of these supernatants on insulin signaling will then be tested. To do so, they will be added or not to cultured HepG2 cells stimulated 24 hours later by 10nM insulin. After stimulation, HepG2 cells will be lysed and their total Akt and phosphorylated Akt content measured by ELISA and Western Blot. The proportion of phosphorylated Akt in HepG2 cells exposed to peripheral blood mononuclear cells supernatant will be compared with the proportion of phosphorylated Akt in HepG2 cells not exposed to peripheral blood mononuclear cells supernatant and expressed as the percentage of insulin signaling inhibition induced by the peripheral blood mononuclear cells supernatant.
Time Frame
Hour 48
Secondary Outcome Measure Information:
Title
A. Percentage inhibition of Akt phosphorylation in Profile 2 patients compared with other immune profiles.
Description
The decrease in signal intensity induced in hepatocytes by insulin induced by peripheral blood mononuclear cell supernatant from volunteers with Profile 2 will be compared to the decrease in this intensity induced by peripheral blood mononuclear cell supernatant from volunteers with another immune activation Profile. Measured as a percentage.
Time Frame
Hour 48
Title
B. Increase in insulinemia over time in Profile 2 patients compared with other immune profiles.
Description
Insulinemia in Profile 2 volunteers, measured in µU/mL, will be compared with that of other immune profiles.
Time Frame
Month 18
Other Pre-specified Outcome Measures:
Title
Age of Profile 2 patients
Description
In years
Time Frame
Day 0
Title
Weight of profile 2 patients
Description
In kg
Time Frame
Day 0
Title
Gender of Profile 2 patients
Description
male / female
Time Frame
Day 0
Title
Waist measurement of Profile 2 patients
Description
In cm
Time Frame
Day 0
Title
Hip circumference of Profile 2 patients
Description
In cm
Time Frame
Day 0
Title
Systolic blood pressure in Profile 2 patients
Description
In mmHg
Time Frame
Day 0
Title
Diastolic blood pressure in Profile 2 patients
Description
In mmHg
Time Frame
Day 0
Title
High-density lipoproteins in Profile 2 patients
Description
mM/L
Time Frame
Day 0
Title
Low-density lipoproteins in Profile 2 patients
Description
mM/L
Time Frame
Day 0
Title
Triglycerides in Profile 2 patients
Description
mM/L
Time Frame
Day 0
Title
Hemoglobin A1c in Profile 2 patients
Description
mM/L
Time Frame
Day 0

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Individuals who participated in the MetACTIV study. Profile 2 subgroup-specific inclusion criteria: MetACTIV study individual with a Profile 2. Persons who have given free informed consent. Persons who have signed the consent form. Persons affiliated to or benefiting from a health insurance plan. Adults (≥18 years of age). Exclusion Criteria: Persons participating in Category 1 research involving human subjects Persons in an exclusion period as determined by another study. Persons under court protection, guardianship or trusteeship. Persons who are incapable of giving consent. Persons for whom it is impossible to give clear information. Pregnant, parturient or breastfeeding woman.
Facility Information:
Facility Name
Centre Hospitalier Universitaire
City
Nîmes
State/Province
Gard
ZIP/Postal Code
30000
Country
France
Facility Name
Caisse Primaire d'Assurance Maladie du Gard
City
Nîmes
State/Province
Gard
ZIP/Postal Code
3000
Country
France

12. IPD Sharing Statement

Plan to Share IPD
No

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Link Between the Peripheral Mononuclear Cells' Capacity to Induce Insulin Resistance and Hyperinsulinemia

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