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Genetic Basis for Prediction of Non-responders to Dietary Plant Sterol Intervention (GenePredict-PS)

Primary Purpose

Hypercholesterolemia, Cardiovascular Disease

Status
Terminated
Phase
Not Applicable
Locations
Canada
Study Type
Interventional
Intervention
Plant sterols
Placebo
Sponsored by
University of Manitoba
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Hypercholesterolemia

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Fasting LDL-C concentration >3.0 and <4.9 mmol/L
  • Fasting glucose concentration <6.1 mmol/L
  • Fasting triglyceride concentration <4.52 mmol/L
  • Genoset required: ; ApoE ε3/ε3 CYP7A1 rs3808607 T/T (n=20); ApoE ε3/ε3 CYP7A1 rs3808607 G/- (n=22); ApoE ε4/- CYP7A1 rs3808607 -/- (n=22)

Exclusion Criteria:

  • Consuming, or have consumed in the last 3 months, medications or nutritional supplements which are known to affect lipid metabolism (such as cholestyramine, colestipol, niacin, clofibrate, gemfibrozil, probucol, HMG-CoA R inhibitors, methotrexate, high dose dietary supplements, fish oil capsules or plant sterol or stanol), or have any dietary restrictions which would prevent them from consuming the trial treatments
  • BMI >40
  • Must not have self-reported weight gain or loss greater than 3 kg in the past three months
  • Phytosterolemic
  • History of active cardiovascular disease including stroke, congestive heart failure, myocardial infarction, unstable angina pectoris, coronary artery bypass graft, percutaneous transluminal coronary angioplasty, temporal ischemic attacks, anemia, abnormal electrolytes, proteinuria, and abnormal liver, kidney or thyroid function
  • Type 1 or type 2 diabetes, a history of cancer or malignancy in the last 5 years, or any metabolic disease, gastrointestinal disorder or other clinically significant disease/disorder which could interfere with the results of the study or the safety of the participant.
  • Uncontrolled hypertension having systolic blood pressure >160mm Hg or diastolic blood pressure >100mm Hg
  • Smoker, tobacco/snuff/nicotine users, recreational drug users
  • Consume more than 14 alcoholic beverages a week
  • Participants who are pregnant or plan to become pregnant during the trial period or lactating mothers
  • Participants will be excluded if they have clinically significant biochemistry defined as: LDL-C <3.0mmol/L or >4.9 mmol/L; TC > 6.2 mmol/L; fasting glucose: > 6.1 mmol/ l, fasting TG >4.52 mmol/L; AST >100 U/L; ALT >100 U/L or or any other clinically significant abnormality in hematology and/or biochemistry at the investigator's discretion
  • Patients with unstable or serious illness, for example, dementia, terminal illness, recent bereavement, recent significant medical diagnosis will also be excluded

Sites / Locations

  • Department of Human Nutritional sciences, University of Manitoba

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Plant sterols

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Change in fasting low-density lipoprotein cholesterol (LDL-C) levels between placebo and treatment endpoints (in a crossover design)

Secondary Outcome Measures

Change in fasting total cholesterol (TC) levels between placebo and treatment endpoints (in a crossover design)
Change in fasting high-density lipoprotein cholesterol levels between placebo and treatment endpoints
Change in fasting triglyceride (TG) levels between placebo and treatment endpoints (in a crossover design)
Change in body weight between placebo and treatment endpoints (in a crossover design)
Change in body mass index (BMI) between placebo and treatment endpoints (in a crossover design)
Change in waist circumference between placebo and treatment endpoints (in a crossover design)
Change in blood pressure between placebo and treatment endpoints (in a crossover design)
Change in arterial stiffness-Pulse wave velocity between placebo and treatment endpoints (in a crossover design)
Pulse wave velocity will be determined using an automated oscillometric measurement device (Mobil-O-Graph, IEM, Stolberg, Germany).
Change in arterial stiffness-augmentation index between placebo and treatment endpoints (in a crossover design)
Augmentation index will be determined using an automated oscillometric measurement device (Mobil-O-Graph, IEM, Stolberg, Germany).
Change in fasting glucose levels between placebo and treatment endpoints (in a crossover design)
Change in blood sterols and sterol precursors (non-cholesterol sterols) levels between placebo and treatment endpoints (in a crossover design)
Change in fractional cholesterol synthesis between placebo and treatment endpoints (in a crossover design)
A fasted blood sample will be taken on day 28 of each study period prior to deuterium oxide administration, as well as fasting samples on day 29. The change in deuterium enrichment within red blood cell (RBC) free cholesterol we be determined as an index of synthesis over days 28 and 29.

Full Information

First Posted
April 22, 2016
Last Updated
May 28, 2020
Sponsor
University of Manitoba
Collaborators
Mitacs, Unilever R&D, Nutritional Fundamentals for Health
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1. Study Identification

Unique Protocol Identification Number
NCT02765516
Brief Title
Genetic Basis for Prediction of Non-responders to Dietary Plant Sterol Intervention
Acronym
GenePredict-PS
Official Title
Genetic Basis for Prediction of Non-responders to Dietary Plant Sterol Intervention
Study Type
Interventional

2. Study Status

Record Verification Date
May 2020
Overall Recruitment Status
Terminated
Why Stopped
Inability to recruit
Study Start Date
July 5, 2017 (Actual)
Primary Completion Date
December 31, 2019 (Actual)
Study Completion Date
December 31, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Manitoba
Collaborators
Mitacs, Unilever R&D, Nutritional Fundamentals for Health

4. Oversight

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

5. Study Description

Brief Summary
The objective of this study is to utilize information on associations between genetic predisposition pertaining to multiple single nucleotide polymorphisms (SNPs) and the degree of responsiveness of low-density lipoprotein cholesterol (LDL-C) lowering to plant sterols (PS). The predictive potential of SNPs associated with PS responsiveness will be evaluated using a randomized human intervention trial examining responsiveness of lowering blood LDL-C levels to PS intervention.
Detailed Description
On average plant sterol (PS) consumption of 2-3 grams a day leads to a ~10% decrease in low-density lipoprotein cholesterol (LDL-C). However, inter-individual response to PS consumption varies, with some individuals showing low or no reductions in LDL-C levels, while some even showing an increase in levels. Determining factors that predict the direction of response of LDL-C to PS would be helpful in identifying individuals who should consume PS and individuals who should seek another method of treating hypercholesterolemia. The objective of this research proposal is to test the a priori predictive potential of a combination of three single nucleotide polymorphisms (SNPs), i.e., genosets, previously associated with response to PS in a post-hoc manner. A clinical trial with a priori recruitment of participants based on genoset which will test LDL-C response to PS consumption using a randomized, double blind, placebo controlled crossover design is proposed.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypercholesterolemia, Cardiovascular Disease

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
43 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Plant sterols
Arm Type
Active Comparator
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Other
Intervention Name(s)
Plant sterols
Intervention Description
2.0g/day of plant sterols incorporated into margarine to be consumed for 28 days
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Identical margarine without additional plant sterols to be consumed for 28 days
Primary Outcome Measure Information:
Title
Change in fasting low-density lipoprotein cholesterol (LDL-C) levels between placebo and treatment endpoints (in a crossover design)
Time Frame
Endpoint (Days 28,29) of each treatment period
Secondary Outcome Measure Information:
Title
Change in fasting total cholesterol (TC) levels between placebo and treatment endpoints (in a crossover design)
Time Frame
Endpoint (Days 28,29) of each treatment period
Title
Change in fasting high-density lipoprotein cholesterol levels between placebo and treatment endpoints
Time Frame
Endpoint (Days 28,29) of each treatment period
Title
Change in fasting triglyceride (TG) levels between placebo and treatment endpoints (in a crossover design)
Time Frame
Endpoint (Days 28,29) of each treatment period
Title
Change in body weight between placebo and treatment endpoints (in a crossover design)
Time Frame
Endpoint (Days 28,29) of each treatment period
Title
Change in body mass index (BMI) between placebo and treatment endpoints (in a crossover design)
Time Frame
Endpoint (Days 28,29) of each treatment period
Title
Change in waist circumference between placebo and treatment endpoints (in a crossover design)
Time Frame
Endpoint (Days 28,29) of each treatment period
Title
Change in blood pressure between placebo and treatment endpoints (in a crossover design)
Time Frame
Endpoint (Days 28,29) of each treatment period
Title
Change in arterial stiffness-Pulse wave velocity between placebo and treatment endpoints (in a crossover design)
Description
Pulse wave velocity will be determined using an automated oscillometric measurement device (Mobil-O-Graph, IEM, Stolberg, Germany).
Time Frame
Endpoint (Days 28,29) of each treatment period
Title
Change in arterial stiffness-augmentation index between placebo and treatment endpoints (in a crossover design)
Description
Augmentation index will be determined using an automated oscillometric measurement device (Mobil-O-Graph, IEM, Stolberg, Germany).
Time Frame
Endpoint (Days 28,29) of each treatment period
Title
Change in fasting glucose levels between placebo and treatment endpoints (in a crossover design)
Time Frame
Endpoint (Days 28,29) of each treatment period
Title
Change in blood sterols and sterol precursors (non-cholesterol sterols) levels between placebo and treatment endpoints (in a crossover design)
Time Frame
Endpoint (Days 28,29) of each treatment period
Title
Change in fractional cholesterol synthesis between placebo and treatment endpoints (in a crossover design)
Description
A fasted blood sample will be taken on day 28 of each study period prior to deuterium oxide administration, as well as fasting samples on day 29. The change in deuterium enrichment within red blood cell (RBC) free cholesterol we be determined as an index of synthesis over days 28 and 29.
Time Frame
Endpoint (Day 28,29) of each treatment period

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Fasting LDL-C concentration >3.0 and <4.9 mmol/L Fasting glucose concentration <6.1 mmol/L Fasting triglyceride concentration <4.52 mmol/L Genoset required: ; ApoE ε3/ε3 CYP7A1 rs3808607 T/T (n=20); ApoE ε3/ε3 CYP7A1 rs3808607 G/- (n=22); ApoE ε4/- CYP7A1 rs3808607 -/- (n=22) Exclusion Criteria: Consuming, or have consumed in the last 3 months, medications or nutritional supplements which are known to affect lipid metabolism (such as cholestyramine, colestipol, niacin, clofibrate, gemfibrozil, probucol, HMG-CoA R inhibitors, methotrexate, high dose dietary supplements, fish oil capsules or plant sterol or stanol), or have any dietary restrictions which would prevent them from consuming the trial treatments BMI >40 Must not have self-reported weight gain or loss greater than 3 kg in the past three months Phytosterolemic History of active cardiovascular disease including stroke, congestive heart failure, myocardial infarction, unstable angina pectoris, coronary artery bypass graft, percutaneous transluminal coronary angioplasty, temporal ischemic attacks, anemia, abnormal electrolytes, proteinuria, and abnormal liver, kidney or thyroid function Type 1 or type 2 diabetes, a history of cancer or malignancy in the last 5 years, or any metabolic disease, gastrointestinal disorder or other clinically significant disease/disorder which could interfere with the results of the study or the safety of the participant. Uncontrolled hypertension having systolic blood pressure >160mm Hg or diastolic blood pressure >100mm Hg Smoker, tobacco/snuff/nicotine users, recreational drug users Consume more than 14 alcoholic beverages a week Participants who are pregnant or plan to become pregnant during the trial period or lactating mothers Participants will be excluded if they have clinically significant biochemistry defined as: LDL-C <3.0mmol/L or >4.9 mmol/L; TC > 6.2 mmol/L; fasting glucose: > 6.1 mmol/ l, fasting TG >4.52 mmol/L; AST >100 U/L; ALT >100 U/L or or any other clinically significant abnormality in hematology and/or biochemistry at the investigator's discretion Patients with unstable or serious illness, for example, dementia, terminal illness, recent bereavement, recent significant medical diagnosis will also be excluded
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James House, PhD
Organizational Affiliation
University of Manitoba
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dylan Mackay, PhD
Organizational Affiliation
University of Manitoba
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Human Nutritional sciences, University of Manitoba
City
Winnipeg
State/Province
Manitoba
ZIP/Postal Code
R3T2N2
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
32487131
Citation
Shamloo M, Granger MJ, Trautwein EA, House JD, MacKay D. Genetic basis for prediction of non-responders to dietary plant sterol intervention (GenePredict-PS): a study protocol for a double-blind, placebo-controlled, randomized two-period crossover study. Trials. 2020 Jun 1;21(1):452. doi: 10.1186/s13063-020-04364-5.
Results Reference
derived

Learn more about this trial

Genetic Basis for Prediction of Non-responders to Dietary Plant Sterol Intervention

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