Clinical trial NCT02373332: Fatty Acid Regulation of Platelet Function in Diabetes
Official title: Fatty Acid Regulation of Platelet Function in Diabetes
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Thrombosis
Type 2 Diabetes Mellitus
Keywords: platelets
12-lipoxygenase
fatty acids
DGLA
DHA
EPA
12-LOX
Lead sponsor: University of Michigan
Sponsor class: OTHER
Collaborators: name: National Heart, Lung, and Blood Institute (NHLBI)
First posted: 2015-02-27
Enrollment: 90
Sex: ALL
Minimum age (years): 21
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Adults ages 21-70. Both female and male and no preference for race or ethnicity. Subjects will abstain from anti-platelet therapy for 10 days. Health status will be confirmed by oral questioning and written questionnaire and confirmed following blood draw prior to evaluation of platelets with fatty acid or oxylipins.

Brief summary: This study investigates the potential protective effects of altering fatty acid in the platelet as a method for prevention of platelet activation and thrombosis in type 2 diabetes mellitus. Fatty acids (omega-3 and omega-6) and their oxidized lipids will be evaluated for protection from agonist-mediated platelet activation in platelets from type 2 diabetics and healthy controls.

Detailed description: 12-lipoxygenase and essential fatty acids such as omega-3 and omega-6 have been shown to play important roles in regulating platelet activation, but the underlying mechanisms have not been fully elucidated as well as their true protection from thrombosis.

12-lipoxygenase inhibition prevents platelet activation in part by inhibiting 12-lipoxygenase oxidation of free fatty acids in the platelet. These oxidized fatty acids are known to play both a pro- and anti-thrombotic effect on platelets depending on the fatty acid. oxidation of arachidonic acid by 12-lipoxygenase results in a pro-thrombotic bioactive lipid whereas oxidation of the omega-6 fatty acid DGLA found in plant oil results in formation of a potent anti-thrombotic bioactive lipid. Determining the extent of protection from this and other bioactive lipids produced through 12-lipoxygenase will allow for a better understanding of which fatty acid supplementation may best protect from thrombosis.

Essential fatty acids such as omega-3 (DHA/EPA) and omega-6 (DGLA) appear to be protective. However the underlying mechanism for this potential protection is not well understood. Identifying the mechanism by which these supplements protect from platelet activation may identify new approaches to preventing thrombotic events in this high risk population.

Eligibility criteria: Inclusion Criteria:

* Healthy subjects and T2DM patients
* African American and Caucasian
* T2DM patients on controlled medication (taking metformin)

Exclusion Criteria:

* Dietary supplement within 2 weeks of enrollment
* Fish and plant oil supplements 2 months prior to enrollment
* NSAIDS and aspirin 1 week prior to enrollment
* Smoking
* Cardiovascular event within 6 months prior to enrollment
* Other anti-platelet treatment including phosphodiesterase (PDE) and P2Y12R inhibitors
* Estimated Glomerular Filtration Rate (eGFR) below 30 (severe renal insufficiency)
* eGFR above 90

Primary outcomes:
measure: inhibition of platelet activation
timeFrame: one-time blood draw
Secondary outcomes:
Other outcomes:
Locations:
city: Ann Arbor
country: United States
facility: University of Michigan
state: Michigan
city: Philadelphia
country: United States
facility: Thomas Jefferson University
state: Pennsylvania
Study officials:
affiliation: University of Michigan
name: Michael Holinstat, PhD
role: PRINCIPAL_INVESTIGATOR
References: