Blood Lipopolysaccharide (LPS) Rifaximin Study
| Status: | Recruiting |
|---|---|
| Conditions: | Endocrine, Endocrine |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 35 - 65 |
| Updated: | 3/16/2019 |
| Start Date: | March 2015 |
| End Date: | June 2019 |
| Contact: | Dorothy Ross |
| Email: | dross3@email.uky.edu |
| Phone: | (859) 323-2737 |
Dietary Fat, Lipoprotein and Lipopolysaccharide: Role in Insulin Resistance
Metabolic syndrome is a condition involving elevated levels of fat in the blood, a tendency
towards diabetes, hypertension, and too much fat around the abdomen (an increased waistline).
Individuals with metabolic syndrome often have impaired glucose tolerance, which is a
condition where blood sugar is normal when fasting (before eating), but is too high after
drinking a sugary drink. This is due to an abnormality in the body's sensitivity to insulin
(insulin resistance), which is due in part to an inability of the muscle to take up glucose.
People with metabolic syndrome have inflammation in their fat tissue and in their blood
stream, and the changes in the level of inflammatory chemicals produced by cells in your fat
tissues will be studied. One possible source of the inflammation may be the bacteria in the
intestine. When individuals eat fatty foods, some of the bacterial products become attached
to the fat in their blood and then get directed to fat tissue. The investigators wish to
determine whether individuals have an excessive amount of inflammation in their fat tissues,
and whether this inflammation comes from the bacteria in their intestines. To determine this,
the investigators wish to treat individuals with an antibiotic that reduces the bacteria in
their intestines and in their blood, and determine whether this reduces their overall level
of inflammation.
towards diabetes, hypertension, and too much fat around the abdomen (an increased waistline).
Individuals with metabolic syndrome often have impaired glucose tolerance, which is a
condition where blood sugar is normal when fasting (before eating), but is too high after
drinking a sugary drink. This is due to an abnormality in the body's sensitivity to insulin
(insulin resistance), which is due in part to an inability of the muscle to take up glucose.
People with metabolic syndrome have inflammation in their fat tissue and in their blood
stream, and the changes in the level of inflammatory chemicals produced by cells in your fat
tissues will be studied. One possible source of the inflammation may be the bacteria in the
intestine. When individuals eat fatty foods, some of the bacterial products become attached
to the fat in their blood and then get directed to fat tissue. The investigators wish to
determine whether individuals have an excessive amount of inflammation in their fat tissues,
and whether this inflammation comes from the bacteria in their intestines. To determine this,
the investigators wish to treat individuals with an antibiotic that reduces the bacteria in
their intestines and in their blood, and determine whether this reduces their overall level
of inflammation.
This is a randomized, placebo controlled proof of concept study that will examine the
investigational drug Rifaximin Soluble Solid Dispersion (SSD) ability to reduce gut
microbiota and thereby reduce adipose inflammation and improve insulin resistance.
Each subject enrolled will undergo a fat tolerance test with a high fat meal, an oral glucose
tolerance test, a fat biopsy, and a euglycemic clamp. Following their successful completion
of those procedures subjects will be randomized to study treatment. That treatment will
involve receiving the investigational drug,80 mg per day of rifaximin soluable solid
dispersion (SDD), or placebo for 8 weeks. All procedures will be performed on the Clinical
Services Core of the CCTS. The initial visit will involve informed consent, and routine labs
(comprehensive metabolic panel, lipid panel, TSH, CBC with platelets). These routine labs are
for safety purposes and to rule out exclusionary disorders. A stool sample will also be
collected and frozen for possible future analysis of bacterial microflora.
Subjects will be asked to allow the principal investigator to bank blood and tissue samples
collected during this study that are not used for other study related tests. No additional
blood or tissue samples will be collected. If the subject agrees to the banking of their
blood and tissue samples they will be stored in the Principal Investigator's laboratory at
the University of Kentucky for an indefinite period of time or until they are used up. Stored
samples will be used for future research testing to learn about how to prevent, detect, or
treat insulin resistance, metabolic syndrome, diabetes or other health problems.
Each subject will undergo total body composition testing using a total body dual-energy x-ray
absorptiometry (DXA) scan. The DXA scan measures the subject's bond density and body fat.
investigational drug Rifaximin Soluble Solid Dispersion (SSD) ability to reduce gut
microbiota and thereby reduce adipose inflammation and improve insulin resistance.
Each subject enrolled will undergo a fat tolerance test with a high fat meal, an oral glucose
tolerance test, a fat biopsy, and a euglycemic clamp. Following their successful completion
of those procedures subjects will be randomized to study treatment. That treatment will
involve receiving the investigational drug,80 mg per day of rifaximin soluable solid
dispersion (SDD), or placebo for 8 weeks. All procedures will be performed on the Clinical
Services Core of the CCTS. The initial visit will involve informed consent, and routine labs
(comprehensive metabolic panel, lipid panel, TSH, CBC with platelets). These routine labs are
for safety purposes and to rule out exclusionary disorders. A stool sample will also be
collected and frozen for possible future analysis of bacterial microflora.
Subjects will be asked to allow the principal investigator to bank blood and tissue samples
collected during this study that are not used for other study related tests. No additional
blood or tissue samples will be collected. If the subject agrees to the banking of their
blood and tissue samples they will be stored in the Principal Investigator's laboratory at
the University of Kentucky for an indefinite period of time or until they are used up. Stored
samples will be used for future research testing to learn about how to prevent, detect, or
treat insulin resistance, metabolic syndrome, diabetes or other health problems.
Each subject will undergo total body composition testing using a total body dual-energy x-ray
absorptiometry (DXA) scan. The DXA scan measures the subject's bond density and body fat.
Inclusion Criteria:
- Obese
- Insulin resistance or metabolic syndrome
- Body Mass Index between 27 and 45
- Waist circumference >40" (M) or >35" (F)
- Impaired glucose tolerance (IGT)
- Normal glucose tolerance (NGT) with at least three features of MetS
- A1C <6.5
- Blood pressure 130/85
Exclusion Criteria:
- Pregnant or breastfeeding
- Recent or unstable cardiovascular disease
- cancer,
- Renal insufficiency (GFR<30)
- Steroid use
- chronic inflammatory conditions
- Anticoagulant use
- Lipodystrophy
- Irritable Bowel Syndrome
- Allergy to local anesthetic
- Lactose intolerance
We found this trial at
1
site
Lexington, Kentucky 40536
Principal Investigator: Philip Kern, MD
Phone: 859-323-9987
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