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临床试验/NCT03860558
NCT03860558进行中(未招募)不适用

Impact of Metabolic Health on Sperm Epigenetic Marks in Humans

Joslin Diabetes Center1 个研究点 分布在 1 个国家目标入组 40 人开始时间: 2018年5月1日最近更新:
适应症
干预措施

试验速览

阶段
不适用
状态
进行中(未招募)
入组人数
40
试验地点
1
主要终点
Spermatozoa concentration

研究概览

简要总结

This study is designed to evaluate whether epigenetic markers in overweight men with type 1 diabetes (T1D) or type 2 diabetes (T2D) can be improved with a 3 month lifestyle intervention or program focused in glycemic intervention.

详细描述

Parental history of diabetes confers substantial individual risk for development of obesity and diabetes. Obesity risk can be transmitted across generations, from parents or grandparents to children. Genomic variation explains only a portion of this risk. Epigenetic modulation through DNA methylation, histone modification, or by noncoding RNAs, provide mechanisms to regulate gene activity independent of DNA sequence by determining which genes are turned on or off in response to environment or disease. Epigenetic changes can be stable over the lifespan providing a mechanism through which environmental exposures may impart long-term effects on gene expression and phenotypic outcome.

The maternal intrauterine environment is now well recognized to modify obesity and T2D disease risk of offspring. Fetuses carried by women who are obese, have diabetes, or suffer from suboptimal nutrition are at increased risk of insulin resistance, obesity, T2D, and cardiovascular disease risk as adults. Studies in rodents also show that the health, metabolism, and prior environmental exposures of the male can also influence health of his offspring. Existing data provide powerful support for the hypothesis that current glucose levels and overall metabolic health of males can alter epigenetic marks in sperm and suggest a novel modifiable mechanism of transmission. However, much less is known about how human sperm epigenetic patterns change with nutritional and metabolic health, and whether these may ultimately impart differences in health of future generations. Thus, we are studying the impact of both type 1 and type 2 diabetes, and elevations in glucose common to both conditions, on human reproductive health and the sperm epigenome.

研究设计

研究类型
Interventional
分配方式
Non Randomized
干预模型
Parallel
主要目的
Basic Science
盲法
None

入排标准

年龄范围
18 Years 至 65 Years(Adult, Older Adult)
性别
Male
接受健康志愿者
是

入选标准

  • •Male, age 18-65 years
  • •Willing and able to provide informed consent and follow all study procedures, including providing sperm specimens 3 months apart.
  • •Type 1 or type 2 diabetes diagnosis confirmed by an endocrinologist (for participants in the diabetes groups)
  • •HbA1c > 7% (for participants in the diabetes groups)
  • •Overweight (BMI > 25 kg/m2) (for all groups, to ensure groups are similar)

排除标准

  • •Chronic kidney disease stage 4 or 5 (including end-stage renal disease);
  • •Hepatic disease, including serum alanine transaminase (ALT) or aspartate aminotransferase (AST) greater than or equal to 3 times the upper limit of normal; hepatic synthetic insufficiency as defined as serum albumin < 3.0 g/dL; or serum bilirubin > 2.0;
  • •Severe diabetic retinopathy;
  • •Congestive heart failure, New York Heart Association (NYHA) class II, III or IV;
  • •History of myocardial infarction, unstable angina or revascularization within the past 6 months;
  • •Active genitourinary infection;
  • •Testicular volume <12 mL (assessed using Prader orchidometer);
  • •Hypogonadism, defined as total testosterone <250 ng/dl;
  • •Hyperprolactinemia, defined as prolactin >18 ng/ml;
  • •Hyperestrogenism, defined as estradiol >42 pg/ml;
  • •Cryptorchidism;
  • •Cigarette smoking;
  • •Active alcohol abuse or substance abuse;
  • •Cancer (except localized non-melanoma skin cancers) or use of chemotherapy agents within 5 years;
  • •Use of nitrates or guanylate cyclase stimulators;
  • •Use of steroid hormones (including testosterone), other than inhalers for reactive airway disease

研究组 & 干预措施

Lifestyle Intervention

Experimental

20 overweight men with T1D or T2D will undergo an intensive 3 month lifestyle intervention program aimed at improving metabolic health, glycemic control, and body weight.

干预措施: Lifestyle Intervention (Other)

Healthy Controls

Active Comparator

10 healthy men will be assessed at baseline and at 3 months. They will not participate in a lifestyle intervention.

干预措施: No Intervention (Other)

No-Intervention Controls

Active Comparator

10 overweight men with T1D or T2D will be assessed at baseline and at 3 months. They will not participate in a lifestyle intervention.

干预措施: No Intervention (Other)

结局指标

主要结局

Spermatozoa concentration

时间窗: 1 year

Sperm will be assessed for concentration, reported as total yield (millions per ml)

次要结局

  • RNA Sequencing(1 year)
  • Sperm DNA methylation, reported as genomic location of regions with methylation altered in response to intervention(1 year)

研究者

申办方类型
Other
责任方
Sponsor

研究点 (1)

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