Clinical Trial: Effects of FXR Activation on Hepatic Lipid and Glucose Metabolism
Study Status: Completed
Recruit Status: Completed
Study Type: Interventional
Official Title: Effects of Activation of the Farnesoid X Receptor (FXR) on Hepatic Lipid and Glucose Metabolism in Patients With the Metabolic Syndrome and Familial Forms of Hypertriglyceridemia
Brief Summary: The purpose of this study is to determine whether chenodeoxycholic acid decreases de novo hepatic lipogenesis, hepatic fat content, hepatic triglyceride production and plasma triglyceride concentrations and improves hepatic glucose metabolism in patients with the metabolic syndrome, Familial Hypertriglyceridemia and Familial Combined Hyperlipidemia.
Detailed Summary:
Insulin resistance has been found to be the key pathophysiological factor of the metabolic syndrome and may precede the onset of impaired glucose tolerance, diabetes and dyslipidemia. Recently, nonalcoholic fatty liver disease (NAFLD), has been identified as another feature of this syndrome. Importantly, a close relation between liver fat content and hepatic insulin sensitivity has been described. We hypothesize that activation of FXR with chenodeoxycholic acid decreases hepatic de novo lipogenesis and subsequently hepatic fat content and triglyceride production. The decrease in liver fat content will be associated with improved hepatic insulin sensitivity and a decrease in hepatic glucose production.
Patients diagnosed with metabolic syndrome, familial hypertriglyceridemia or familial combined hyperlipidemia will be recruited from the the outpatients department of the Division of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Basel. Eligible patients will be admitted to the CRC for metabolic studies, including baseline blood samples for the measurement of hormones, cytokines and adipokines, euglycemic-hyperinsulinemic clamp studies for the assessment of glucose turnover and insulin sensitivity and in vivo NMR studies to determine intrahepatic and intramyocellular lipid content. Patients will alternatively receive chenodeoxycholic acid and placebo. The study population will be compared to a group of age, gender and weight matched normolipidemic controls.
Sponsor: University Hospital, Basel, Switzerland
Current Primary Outcome: plasma triglyceride concentrations [ Time Frame: 3 months ]
Original Primary Outcome:
Current Secondary Outcome:
- hepatic insulin sensitivity [ Time Frame: 3 months ]
- heptic triglyceride content [ Time Frame: 3 months ]
Original Secondary Outcome:
Information By: University Hospital, Basel, Switzerland
Dates:
Date Received: April 24, 2007
Date Started: October 2004
Date Completion:
Last Updated: March 8, 2012
Last Verified: March 2012
