Official Title

Lipid Biomarkers for Diabetic Heart Disease
  • Phase

    N/A
  • Study Type

    Interventional
  • Intervention/Treatment

    fenofibrate ...
  • Study Participants

    70
This study will test whether lowering the delivery of excess fats to the heart in persons with type-2 diabetes mellitus improves heart muscle function. The investigators will also test whether specific lipid molecular species in plasma can serve as biomarkers for diabetic heart disease.
Screening procedures include 12-hour fasting blood draw, urine pregnancy testing for females, completion of medical history questionnaire, and stress echocardiography to rule out coronary artery disease or cardiomyopathy.

Subjects who meet screening criteria will return for visit 2, which consists of a urine collection, 12-hour fasting blood draw, dual-energy X-ray absorptiometry (DXA) for body composition, magnetic resonance spectroscopy analysis of the liver, and resting echocardiogram for analysis of heart structure and function. Subjects will then be randomized to treatment with fenofibrate (160 mg/d) or an identical-appearing placebo for 12 weeks. They will be asked to continue their usual medications, diet and physical activity. Subjects will receive a pedometer to wear daily to track their physical activity. Subjects will meet with dietitians from the Lifestyle Intervention Core to complete a 24-hour dietary recall. They will be instructed to record their daily blood glucose concentrations, distance walked and any side effects, illnesses or stresses in a study-supplied log. Subjects will be instructed to either email or fax the log to the study coordinator each week (or discuss by phone).

Subjects will return 6 weeks after starting intervention for visit 3 to ensure their medical safety. Procedures at this visit include an interim medical history, urine pregnancy test for females, blood draw to rule out untoward effects of the study drug on liver or kidney function, pill count to assess compliance, review of logs of blood glucose, distance walked, and side effects, illnesses or stresses, and meeting with a dietitian for a 24-hour dietary recall.

Subjects will continue to take their study medication/placebo and keep logs of blood glucose levels, distance walked, and side effects, illnesses and stresses for another 6 weeks. They will return for visit 4 after 12 total weeks of intervention. Visit 4 involves a urine collection, 12-hour fasting blood draw, review of subject logs, pill count, and 24-hour dietary recall. In addition, magnetic resonance spectroscopy analysis of the liver and resting echocardiogram analysis of the heart will be performed to determine if there have been any changes in liver fat or heart function during the 12-week intervention.
Study Started
Mar 31
2013
Primary Completion
Feb 23
2018
Study Completion
Feb 23
2018
Results Posted
Feb 26
2019
Last Update
Mar 15
2019

Drug Fenofibrate

  • Other names: Tricor, Triglide, Antara, Lipofen

Drug Placebo for fenofibrate

  • Other names: Sugar pill manufactured to mimic Fenofibrate 160 mg capsule

Fenofibrate Experimental

One fenofibrate 160 mg capsule per day for 12 weeks

Placebo for fenofibrate Placebo Comparator

One inert sugar pill per day for 12 weeks

Criteria

Inclusion Criteria:

Type 2 diabetes mellitus

Exclusion Criteria:

body weight > 300 lb.
HIV
hypothyroid
steroid medication, fenofibrate
smoking
BP > 140/90
heart disease
pregnant or lactating
consumption of > 5 alcoholic drinks/wk
creatinine > 1.5 mg/dL
hematocrit < 28

Summary

Fenofibrate

Placebo for Fenofibrate

All Events

Event Type Organ System Event Term Fenofibrate Placebo for Fenofibrate

Change in Cardiac Diastolic Function as Measured by E' (cm/s)

Change was measured by echocardiography and was calculated as the value at 12 weeks minus the value at baseline.

Fenofibrate

-0.02
cm/s (Mean)
Standard Deviation: 1.35

Placebo for Fenofibrate

0.55
cm/s (Mean)
Standard Deviation: 1.58

Change in Cardiac Systolic Function as Measured by Fractional Shortening Percent

Change was measured by echocardiography and was calculated as the value at 12 weeks minus the value at baseline.

Fenofibrate

0.025
percent (Mean)
Standard Deviation: 0.090

Placebo for Fenofibrate

0.03
percent (Mean)
Standard Deviation: 0.083

Change in C24:0/C16:0 Ceramide Ratio

Mass spectrometry-based quantification of the ratio of C24:0 ceramide to C16:0 ceramide in plasma.

Fenofibrate

-1.6
ratio (Mean)
Standard Deviation: 1.66

Placebo for Fenofibrate

-0.03
ratio (Mean)
Standard Deviation: 2.44

Total

70
Participants

Age, Continuous

54.4
years (Mean)
Standard Deviation: 8.2

C24:0/C16:0 ceramides

11.8
ratio (Mean)
Standard Deviation: 2.8

Cardiac Diastolic Function (E')

8.1
cm/s (Mean)
Standard Deviation: 1.7

Cardiac Systolic Function (Fractional Shortening)

38.2
percent (Mean)
Standard Deviation: 6.7

Ethnicity (NIH/OMB)

Race (NIH/OMB)

Region of Enrollment

Sex: Female, Male

Overall Study

Fenofibrate

Placebo for Fenofibrate

Drop/Withdrawal Reasons

Fenofibrate

Placebo for Fenofibrate