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The Impact of Gall Bladder Emptying and Bile Acids on the Human GLP-1-secretion

Not Applicable
Completed
Conditions
To Assess the Impact of Bile Acids on Human Glukagon-like-peptide-1 Secretion
Interventions
Other: Saline
Other: Cholecystokinin-8
Registration Number
NCT01656057
Lead Sponsor
Filip Krag Knop
Brief Summary

The last couple of years it has been shown that bile acids not only acts as simple emulsifiers of fat, but constitutes a complex metabolic integrator which not only have an influence on fat digestion and lipid metabolism, but also modulates the energy expenditure in (brown) adipose tissue and muscle tissue. This action is due to stimulation of the receptor TGR5 by bile acids. Recently scientists have discovered that this receptor in rodents is also expressed on the surface of intestinal L-cells (which normally secrets Glucagon-Like Peptide-1 (GLP-1) in response to nutrient stimulation). The stimulation of this receptor has shown a GLP-1 secretion from the intestinal cells which is interesting since GLP-1 has a central role in maintaining normal glucose tolerance and thus blood sugar. Given the above, bile acids has an important impact on intestinal GLP-1 secretion. Whether these scientific findings can be proven in human beings is uncertain.

The primary hypothesis is that stimulating gall bladder emptying via Cholecystokinin (CCK) in healthy subjects will result in a significant GLP-1 response. We also hypothesize that adding orally Metformin or a sequestrant ("a bile acid binder") will further enhance this GLP-1 response.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
10
Inclusion Criteria
  • HbA1c < 6,0%
  • Not anaemic
  • Written informed consent
Exclusion Criteria
  • Liver disease
  • Nephropathy
  • fasting plasma glucose > 5,6mM
  • Diabetes running in the family (parents or grandparents)
  • Any medical treatment
  • A former medical history of liver- or bile disease
  • any surgical procedure conducted in the abdomen
  • Body mass index < 18,5 kg/m2 or > 25 kg/m2

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Acetaminophen+salineSalineAcetaminophen tablet 1500 mg via nasogastric tube + i.v. saline
Colesevelam+salineSalineColesevelam tablet 3750 mg + Acetaminophen tablet 1500 mg via nasogastric tube + iv. saline
Colesevelam+CCKAcetaminophenColesevelam tablet 3750 mg + Acetaminophen tablet 1500 mg via nasogastric tube + iv. CCK-8, 24 pmol/kg/hour
Acetaminophen+CCKAcetaminophenAcetaminophen tablet 1500 mg via nasogastric tube + iv. CCK-8, 24 pmol/kg/hour
Acetaminophen+CCKCholecystokinin-8Acetaminophen tablet 1500 mg via nasogastric tube + iv. CCK-8, 24 pmol/kg/hour
Metformin+salineSalineMetformin tablet 1500 mg + Acetaminophen tablet 1500 mg via nasogastric tube + i.v. saline
Metformin+CCKCholecystokinin-8Metformin tablet 1500 mg + Acetaminophen tablet 1500 mg via nasogastric tube + iv. CCK-8, 24 pmol/kg/hour
Colesevelam+salineColesevelamColesevelam tablet 3750 mg + Acetaminophen tablet 1500 mg via nasogastric tube + iv. saline
Colesevelam+CCKCholecystokinin-8Colesevelam tablet 3750 mg + Acetaminophen tablet 1500 mg via nasogastric tube + iv. CCK-8, 24 pmol/kg/hour
Acetaminophen+salineAcetaminophenAcetaminophen tablet 1500 mg via nasogastric tube + i.v. saline
Metformin+salineAcetaminophenMetformin tablet 1500 mg + Acetaminophen tablet 1500 mg via nasogastric tube + i.v. saline
Metformin+salineMetforminMetformin tablet 1500 mg + Acetaminophen tablet 1500 mg via nasogastric tube + i.v. saline
Metformin+CCKAcetaminophenMetformin tablet 1500 mg + Acetaminophen tablet 1500 mg via nasogastric tube + iv. CCK-8, 24 pmol/kg/hour
Metformin+CCKMetforminMetformin tablet 1500 mg + Acetaminophen tablet 1500 mg via nasogastric tube + iv. CCK-8, 24 pmol/kg/hour
Colesevelam+salineAcetaminophenColesevelam tablet 3750 mg + Acetaminophen tablet 1500 mg via nasogastric tube + iv. saline
Colesevelam+CCKColesevelamColesevelam tablet 3750 mg + Acetaminophen tablet 1500 mg via nasogastric tube + iv. CCK-8, 24 pmol/kg/hour
Primary Outcome Measures
NameTimeMethod
GLP-1 response as incremental area under curve (iAUC)-30, -15, 0, 10, 20, 30, 40, 50, 60, 90, 120, 150, 180, 240
Secondary Outcome Measures
NameTimeMethod
Insulin-30, -15, 0, 10, 20, 30, 40, 50, 60, 90, 120, 150, 180, 240

Trial Locations

Locations (1)

University Hospital of Copenhagen, Gentofte Hospital, Diabetic Research Division

🇩🇰

Copenhagen, Hellerup, Denmark

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