Effects of Melatonin Supplementation on Renal Physiology in a Habitual Sleep Restricted Population.
试验速览
- 阶段
- 2 期
- 状态
- 终止
- 入组人数
- 12
- 试验地点
- 1
- 主要终点
- Change in Renal Specific Renin-aldosterone-angiotensin System (RAAS) Activity
研究概览
简要总结
In a 6 week pilot study, 20 individuals with habitual sleep restriction will all be asked to extend their nightly sleep by 1 hour, and will then be randomized 1:1 to nightly controlled-release oral melatonin (2mg) or placebo. The investigators will assess whether sleep extension and nightly melatonin supplementation in the community is a feasible intervention with a beneficial effect on the following chronic kidney disease (CKD) risk factors: systemic and renal specific renin-aldosterone-angiotensin system (RAAS) activation (systemic plasma renin activity, plasma angiotensin II levels, 24-hour urine aldosterone excretion, and renal plasma flow response to captopril); nocturnal blood pressure measured by 24-hour ambulatory blood pressure monitor; central blood pressure measured by pulse wave analysis; and glucose metabolism measured by Minimal Model assessment of insulin resistance and β-cell response to a mixed meal protocol.
详细描述
The investigators will recruit individuals from the Boston area who meet the inclusion and exclusion criteria. The investigators will include both men and women and all races and ethnicities. The only exception will be women who are pregnant because certain medications used during the inpatient evaluations (e.g., nitroglycerine), and certain study medications (i.e., captopril) are contraindicated during pregnancy.
Participant Enrollment
Responders to advertisements will be pre-screened by telephone to obtain a body mass index (BMI) estimate and a medical history to gauge potential eligibility. For participants who may be eligible following this phone query, the basic study schema will be described to identify those who remain interested in participation after learning the duration, inpatient requirements, and potential medication use. These individuals will then be invited to attend an outpatient screening visit.
The pilot study is a double-blind, placebo-controlled randomized trial, in which 16 subjects with obesity (body mass index [BMI] ≥30 kg/m2), pre-diabetes (hemoglobin A1C [HbA1C], 5.7-6.4%), and self-reported short sleep duration (<7 hours/night) are randomly assigned 1:1 to receive either placebo or 2 mg of controlled-release melatonin, taken orally every evening 1 hour before bed for 6 weeks. All subjects will be asked to extend their sleep time by one hour during the 6 week period between inpatient visits. Endpoints will be measured at both the baseline and 6-week inpatient visits.
Screening Visit: Screening visits will take place at the Brigham and Women's Outpatient Center for Clinical Investigation During the outpatient screen, Dr. McMullan will explain the study in detail, review the consent form, and answer questions. After obtaining written informed consent for participation, a history and physical examination will be performed in order to initially judge eligibility based upon the criteria set out in that section of this record. Participants deemed potentially eligible based upon the screening history and exam will undergo phlebotomy and analysis for HbA1c, serum chemistries and glucose, and complete blood count (CBC) to confirm eligibility using the criteria presented in the table.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Basic Science
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Body Mass Index (BMI) ≥ 30 kg/m2
- •Hemoglobin A1c (HbA1c) 6.7-6.4%
- •Self reported sleep < 7 hours per night
排除标准
- •Inability to extend sleep by one hour each night
- •Current or prior history of diabetes OR random serum glucose ≥200mg/dL
- •Pregnancy
- •Preexisting lung disease requiring oxygen
- •Preexisting cardiovascular disease
- •Active or uncontrolled psychotic disorder
- •Active or uncontrolled bipolar illness
- •Active malignancy with in the prior 5 years
- •Use of hypoglycemic medication
- •estimated glomerular filtration rate (eGFR) <60ml/min/1.73m2
- •Use of antihypertensive medications
- •Hepatic impairment
- •Job requiring rotating overnight shifts
- •Bariatric surgery within prior 12 months
- •Use of hypnotic medications
- •Hematocrit <34% (women), <36% (men)
研究组 & 干预措施
Melatonin
Circadin, controlled release melatonin tablet 2mg by mouth each day before bedtime for 6 weeks
干预措施: Melatonin (Drug)
Placebo
Placebo tablet identical to Circadin by mouth each day before bedtime for 6 weeks
干预措施: Placebo (Drug)
结局指标
主要结局
Change in Renal Specific Renin-aldosterone-angiotensin System (RAAS) Activity
时间窗: 6 weeks
renal specific RAAS activity will be assessed via para-aminohippurate (PAH) renal plasma flow testing with captopril
Change in Systemic Renin-aldosterone-angiotensin System (RAAS) Activity
时间窗: 6 weeks
systemic RAAS will be assessed by plasma renin activity (PRA), angiotensin II (Ang II) levels and urine aldosterone
次要结局
- Change in Central Blood Pressure(6 weeks)
- Change in Glucose Metabolism(6 weeks)
研究者
Ciaran McMullan
Instructor of Medicine
Brigham and Women's Hospital
