Effects of Metformin on Hepatic FFA Metabolism
Primary Purpose
Type 2 Diabetes, Dyslipidemia
Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Metformin
Placebo
Sponsored by
About this trial
This is an interventional basic science trial for Type 2 Diabetes focused on measuring Type 2 diabetes, Hepatic fatty acid oxidation, Dyslipidemia, Metformin
Eligibility Criteria
Inclusion Criteria:
- Recently diagnosed type 2 diabetes
- Age 50-70 years
- BMI<40
Exclusion Criteria:
- Insulin treatment
- NASH (non alcoholic steatohepatitis)
- Cancer
- Anemia
- HbA1C>8.5 %
- Chronic or acute pancreatitis
- Alcohol or medicine abuse
- Allergy towards metformin
- Claustrophobia
- Severe obesity (weight >130 kilogram)
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Other
Placebo Comparator
Active Comparator
Arm Label
Healthy controls
Placebo
Metformin
Arm Description
Healthy controls receiving 1000 mg metformin twice daily for 3 months
Placebo
Metformin "Sandoz", 1000 mg twice daily for 3 months
Outcomes
Primary Outcome Measures
Hepatic Fatty Acid Oxidation
Hepatic fatty acid oxidation assessed by dynamic C11-palmitate PET
Hepatic Fatty Acid Reesterification
Hepatic fatty acid reesterification assessed by C11-palmitate PET
Hepatic Fatty Acid Uptake
Hepatic fatty acid uptake assessed by C11-palmitate PET
VLDL-TG Secretion
Hepatic VLDL-TG secretion assessed by [1-14C] VLDL tracer
Whole Body Glucose Rd
Whole body basal glucose metabolism assessed by [3-3H]glucose tracer kinetics
Secondary Outcome Measures
Fatty Acid Turnover
Fatty acid turnover assessed as whole body C11-palmitate turnover
VLDL-TG Oxidation
VLDL-TG oxidation assessed by 14C carbon dioxide (CO2) in exhaled breath
Full Information
NCT ID
NCT01729156
First Posted
November 13, 2012
Last Updated
September 24, 2019
Sponsor
Lars Christian Gormsen
1. Study Identification
Unique Protocol Identification Number
NCT01729156
Brief Title
Effects of Metformin on Hepatic FFA Metabolism
Official Title
Effects of Metformin on Hepatic Free Fatty Acid Metabolism in Patients Diagnosed With Type 2 Diabetes: A C11 PET Study
Study Type
Interventional
2. Study Status
Record Verification Date
September 2019
Overall Recruitment Status
Completed
Study Start Date
January 2013 (undefined)
Primary Completion Date
May 5, 2017 (Actual)
Study Completion Date
May 5, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Lars Christian Gormsen
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Background: Metformin treatment has beneficial effects on both glucose and lipid metabolism. Whereas there is general agreement that the blood glucose lowering effect of metformin results from inhibition of hepatic gluconeogenesis, it is less clear exactly how the drug lowers blood triglyceride concentration. There are indications that it enhances hepatic free fatty acid (FFA) oxidation thus diminishing substrate for reesterification and resecretion as very-low-density-lipoprotein (VLDL) triglycerides (TG). However, the liver is not easily accessible for sampling in humans and data on the clinical effects of metformin in the liver are therefore lacking. This may change due to the increasing use of the positron emission tomography (PET) technique. Using PET isotopes (11C or 18F) coupled to either palmitate or a fatty acid analogue, it is possible to non-invasively measure hepatic fatty acid handling.
Aim: To determine how 3 months metformin treatment (1000 mg twice daily) affects hepatic lipid and glucose metabolism in patients with newly diagnosed type 2 diabetes.
Design: Randomized, placebo controlled, double-blind parallel study with patients receiving either metformin or placebo. A control group of BMI and age-matched non-diabetic individuals will receive metformin for 3 months.
Hypothesis: Metformin lowers VLDL-TG secretion and circulating triglycerides by increasing hepatic fatty acid oxidation
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 2 Diabetes, Dyslipidemia
Keywords
Type 2 diabetes, Hepatic fatty acid oxidation, Dyslipidemia, Metformin
7. Study Design
Primary Purpose
Basic Science
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
36 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Healthy controls
Arm Type
Other
Arm Description
Healthy controls receiving 1000 mg metformin twice daily for 3 months
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo
Arm Title
Metformin
Arm Type
Active Comparator
Arm Description
Metformin "Sandoz", 1000 mg twice daily for 3 months
Intervention Type
Drug
Intervention Name(s)
Metformin
Other Intervention Name(s)
Metformin "Sandoz" 500 mg
Intervention Description
1000 mg metformin twice daily in 3 months
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
2 tablets twice daily in 3 months
Primary Outcome Measure Information:
Title
Hepatic Fatty Acid Oxidation
Description
Hepatic fatty acid oxidation assessed by dynamic C11-palmitate PET
Time Frame
90 days
Title
Hepatic Fatty Acid Reesterification
Description
Hepatic fatty acid reesterification assessed by C11-palmitate PET
Time Frame
90 days
Title
Hepatic Fatty Acid Uptake
Description
Hepatic fatty acid uptake assessed by C11-palmitate PET
Time Frame
90 days
Title
VLDL-TG Secretion
Description
Hepatic VLDL-TG secretion assessed by [1-14C] VLDL tracer
Time Frame
90 days
Title
Whole Body Glucose Rd
Description
Whole body basal glucose metabolism assessed by [3-3H]glucose tracer kinetics
Time Frame
90 days
Secondary Outcome Measure Information:
Title
Fatty Acid Turnover
Description
Fatty acid turnover assessed as whole body C11-palmitate turnover
Time Frame
90 days
Title
VLDL-TG Oxidation
Description
VLDL-TG oxidation assessed by 14C carbon dioxide (CO2) in exhaled breath
Time Frame
90 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Recently diagnosed type 2 diabetes
Age 50-70 years
BMI<40
Exclusion Criteria:
Insulin treatment
NASH (non alcoholic steatohepatitis)
Cancer
Anemia
HbA1C>8.5 %
Chronic or acute pancreatitis
Alcohol or medicine abuse
Allergy towards metformin
Claustrophobia
Severe obesity (weight >130 kilogram)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lars C Gormsen, MD PhD
Organizational Affiliation
Aarhus University Hospital
Official's Role
Principal Investigator
12. IPD Sharing Statement
Citations:
PubMed Identifier
30976851
Citation
Gormsen LC, Sondergaard E, Christensen NL, Brosen K, Jessen N, Nielsen S. Metformin increases endogenous glucose production in non-diabetic individuals and individuals with recent-onset type 2 diabetes. Diabetologia. 2019 Jul;62(7):1251-1256. doi: 10.1007/s00125-019-4872-7. Epub 2019 Apr 11.
Results Reference
derived
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Effects of Metformin on Hepatic FFA Metabolism
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