Effect of Apelin on Insulin Sensitivity: Proof of Concept in Healthy Volunteers

Study Overview
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Brief Summary
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The (PYR1)-apelin-13 is an endogenous peptide discovered relatively recently (1998). The apelin and its receptor, which is named apj, are expressed in many tissues including sensitive to the action of insulin, such as skeletal muscle, adipose tissue and heart tissue. Recent work by the team of Prof. P.Valet (INSERM U1048, Toulouse) opened a new field of investigation, demonstrating for the first time in mouse models that apelin exerts a glucose-regulating in vivo action. The investigators propose a translational clinical research project whose goal is to provide the proof of concept of the favorable influence of apelin on insulin sensitivity in humans.

Official Title
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Effect of Apelin on Insulin Sensitivity: Proof of Concept in Healthy Volunteers

Conditions
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Healthy

Intervention / Treatment
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* Drug: Apelin
* Drug: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men aged 18 to 40 years. BMI between 25 and 30 kg / cm ² (excluding terminals). Free of known chronic disease and any medication (any medication within 30 days prior to the inclusion visit). Non-pathological ECG. Heart rate between 50 and 80 beats per minute rest. Complete Blood Count (CBC) with no significant anomaly in terms of the investigator. Liver function tests without clinically significant abnormalities in terms of the investigator. Renal function tests without clinically significant abnormalities in terms of the investigator. Serum electrolytes without clinically significant abnormalities in terms of the investigator. Fasting plasma glucose less than 1.1 g / l. HbA1c within the normal range (4-6%). Good peripheral vein (forearm and back of the hand). Agreement to participate in the establishment of a serum bank. Sedentary or practicing occasional physical activity. Ability to sign informed consent. Affiliation to a social security scheme. Exclusion Criteria: Risk factor, treatment or ECG as recommended by International Conference on Harmonization E14 (ICH E14) Clinical Evaluation of QT / corrected QT interval (QTc Interval= Prolongation and Proarrhythmic Potential for Non-Antiarrhythmic Drugs Repeated a QTc interval> 450 ms measurement Risk factor: myocardial infarction, hypokalemia, family history of long QT syndrome Personal history of cancer. Positive HIV serology. Hepatitis B serology positive. Positive hepatitis C serology. Cognitive impairment or mental illness (at the discretion of the investigator). Chronic excessive alcohol consumption (consumption> 30g/jour or 210g/week). Person under judicial protection, guardianship. Subject with a resting systolic blood pressure greater than 140 mm Hg and diastolic blood pressure greater than 90 mmHg Smoking> 10 cig / day and can not be interrupted for 24 hours. Subject exclusion period of another protocol.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Apelin<br>An apelin clamp in which an apelin infusion will be administered prior to reference clamp | Drug: Apelin<br>* An apelin clamp in which an apelin infusion will be administered<br>Drug: Placebo<br>* A clamp reference during which a placebo solution (saline solution) will be administered<br>|
| Placebo Comparator: Placebo<br>A clamp reference during which a placebo solution (saline solution) will be administered prior to apelin clamp | Drug: Apelin<br>* An apelin clamp in which an apelin infusion will be administered<br>Drug: Placebo<br>* A clamp reference during which a placebo solution (saline solution) will be administered<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of glucose infusion | Measuring the difference between the rate of glucose infusion measured in the last 30 minutes of a hyperinsulinemic euglycemic clamp in the presence of a continuous infusion (PYR1)-apelin-13 infusion rate of glucose measured in the same conditions in the presence of a continuous infusion of placebo. | The last 30 minutes of a hyperinsulinemic euglycemic clamp | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Calculation of the index of insulin sensitivity (Si) |  | During 240 minutes at visits 2 and 3 | 
| Changes in the measurement of systolic blood pressure during each clamp |  | During 240 minutes at visits 2 and 3 | 
| Changes in the measurement of diastolic blood pressure during each clamp |  | During 240 minutes at visits 2 and 3 | 
| Changes in heart rate measurement during each clamp |  | During 240 minutes at visits 2 and 3 | 
| Changes in ECG during each clamp |  | During 240 minutes at visits 2 and 3 | 
| Clinical signs of intolerance / allergy / toxicity at visit 2,3 and 4 |  | During 240 minutes at visits 2 and 3 | 
| Determination of plasma insulin at all sampling |  | During 240 minutes at visits 2 and 3 | 
| Determination of plasma glucagon at all sampling times |  | During 240 minutes at visits 2 and 3 | 
| Determination of plasma apelin at all sampling times |  | During 240 minutes at visits 2 and 3 | 
| Determination of plasma leptin at all sampling times |  | During 240 minutes at visits 2 and 3 | 
| Determination of plasma adiponectin at all sampling times |  | During 240 minutes at visits 2 and 3 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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insulin, Apelin, volunteers