11ß-HSD1 and Metabolic Syndrome

Study Overview
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Brief Summary
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The purpose of this study is to determine whether the insulin sensitizing effects of rosiglitazone were accompanied by changes in 11ß-HSD1 expression and activity in different tissues. Furthermore the metabolic and hormonal effects of PPAR gamma stimulation by rosiglitazone will be analysed in several tissues.

Detailed Description
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The PPARgamma agonist rosiglitazone (R) increases insulin sensitivity, which is comparable to the effects of a reduction in 11ß-hydroxysteroid dehydrogenase type 1 (11β-HSD1) activity in animal models. We therefore aimed to investigate whether rosiglitazone-induced insulin sensitivity is associated with changes in 11β-HSD1 activity in different tissues in subjects suffering from impaired glucose tolerance. Furthermore the metabolic and hormonal effects of PPAR gamma stimulation by rosiglitazone will be analysed in those tissue samples.

Official Title
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The Pathogenic Role of 11ß-hydroxysteroid Dehydrogenase in the Metabolic Syndrome - the Effect of Rosiglitazone

Conditions
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Metabolic Syndrome, Impaired Glucose Tolerance

Intervention / Treatment
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* Drug: rosiglitazone


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Impaired glucose tolerance Exclusion Criteria: Treatment with insulin Orally taken antidiabetic medication, glucocorticoids or vitamin K-antagonists Heart failure Impaired hepatic or renal function Anaemia Disturbed coagulation Any other endocrine disorder

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Rosiglitazone treatment<br>Rosiglitazone will be given to the subjects. All subjects will be analyzed before and after treatment | Drug: rosiglitazone<br>* 89 mg BID for 8 weeks, orally<br>* Other names: Avandia;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| changes of 11ß-HSD1 expression in adipose tissue and skeletal muscle during 8 weeks of rosiglitazone treatment | 11ß-HSD1 expression will be measured in adipose tissue and skeletal muscle | 8 weeks | 
| changes of hepatic 11ß-HSD1 activity during 8 weeks of rosiglitazone treatment | 11ß-HSD1 activity will be assessed by measuring conversion of cortisone to cortisol (ratio will be calculated) | 8 weeks | 
| changes of whole body 11ß-HSD1 activity during 8 weeks of rosiglitazone treatment | whole body 11ß-HSD1 activity will be assessed by measuring the ratio of urinary tetrahydrocortisol (THF) + alpha-tetrahydrocortisol (THF) / tetrahydrocortisone | 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| changes in insulin sensitivity during 8 weeks of rosiglitazone treatment | Measurement of whole body and myocellular insulin sensitivity (mg•kg-1•min-1/(mU•L-1)) before and after treatment | 8 weeks | 
| Hormonal and metabolic changes induced by the intervention | Whole body as well as tissue specific (skeletal muscle and different adipose tissue compartment) changes in hormonal circuits and metabolism will be analyzed | 3 months | 
| changes of FGF-21 induced by the intervention | FGF-21 (ng/ml) will be assessed in plasma samples | 8 weeks | 
| changes of free fatty acids (FFA) induced by the intervention | FFA (mmol/l) will be assessed in plasma samples | 8 weeks | 
| changes of myocellular SCD1 expression induced by the intervention | myocellular SCD1 mRNA expression will be assessed | 8 weeks | 
| changes of myocellular long chain fatty acids (LC-FA) expression induced by the intervention | myocellular LC-FA mRNA expression will be assessed | 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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11ß-hydroxysteroid dehydrogenase, rosiglitazone, insulin sensitivity, Impaired glucose tolerance