Primary Objective: To determine the differences in function and morphology of the distinct abdominal adipose tissue depots (e.g. SAT, PVAT, OAT and MAT; see figure 1) in patients undergoing elective open abdominal aortic surgery.Secondary…
ID
Source
Brief title
Condition
- Endocrine and glandular disorders NEC
- Aneurysms and artery dissections
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Differences in function and morphology between the distinct abdominal adipose
tissue depots, by comparing:
- The secretion profile of adipocytokines ex vivo measured with LUMINEX and
ELISA
- The mean difference in basal mRNA expression of adipocytokines of the adipose
tissues, measured by quantitative RT-PCR and
- The mean differences in morphology, measured by number and size of
adipocytes, capillaries, inflammatory cells and ischemia.
- The mean differences in number of specific inflammatory cells present in
subcutaneous versus visceral adipose tissue.
Secondary outcome
1. Mean differences in quantity of the distinct adipose tissue depots measured
from images of routinely performed CT scans, correlated to differences in
functional and/or morphological parameters of the adipose tissue depots like
adipocytokine secretion pattern or mean adipocyte cell size.
2. Difference between independent correlations of the different AT depots with
clinical parameters of the metabolic syndrome. Therefore functional and/or
morphological parameters of each adipose tissue depot (like adipocytokine
secretion pattern or mean adipocyte cell size) will be correlated to clinical
parameters of the patient and correlations between the distinct adipose tissue
depots will be compared.
3. Mean differences in function and morphology of the distinct adipose tissue
depots, correlated to systemic plasma concentrations of bioactive mediators.
Background summary
Adipose tissue is an important endocrine organ, reacting actively on nutrients
and stress. The increase in wealth results in an increase in obesity, metabolic
syndrome and unhealthy habits like smoking. These lead to metabolic
disturbances, which is a risk factor for cardiovascular disease. Adipose tissue
plays an important pathological role in cardiovascular disease, by secretion of
inflammatory factors. In order to understand tha pathological pathway and
subsequently develop therapeutical strategies, accurate knowledge of metabolic
tissues and mechanisms is crucial. In the last decades, much research has been
performed to clarify these metabolic mechanisms, and many bioactive mediators
secreted by metabolically challenged adipose tissue were found to form a link
between obesity and cardiovascular disease. However, many links are still
missing and current known mediators have not yet been satisfying in the use for
diagnostics or therapeutic purposes. Therefore it remains necessary to study
the adipose tissues of humans suffering from cardiovascular disease, to unravel
the mechanisms whereby adipose tissue contributes to cardiovascular disease.
From imaging studies there are indications that different adipose tissue
regions in the body contribute differently to cardiovascular disease. By
studying adipose tissue derived from the different regions in the abdomen, from
patients suffering from severe vascular disease, we might detect differences
among these regions and clues for the mechanisms by which adipose tissue
contributes to vascular disease.
This research proposal focuses on the contribution of the distinct abdominal
adipose tissue depots in the secretion of pathogenic mediators for vascular
disease. The ability to retrieve tissues from patients undergoing abdominal
surgery for an abdominal aortic aneurysm (AAA) or occlusive atherosclerosis
provides the unique possibility to study the contribution of distinct adipose
tissue depots to severe vascular disease.
The study population will consist of 30 male or female subjects, 18-80 years of
age, referred to the UMC Utrecht for elective abdominal aortic surgery for
either abdominal aortic aneurysms or atherosclerotic occlusion.
Study objective
Primary Objective:
To determine the differences in function and morphology of the distinct
abdominal adipose tissue depots (e.g. SAT, PVAT, OAT and MAT; see figure 1) in
patients undergoing elective open abdominal aortic surgery.
Secondary objectives
1. To determine if the differences in quantity between the distinct abdominal
adipose tissue depots, measured from routinely performed CT images of patients
undergoing elective open abdominal aortic surgery, can be related to
differences in function and morphology between the adipose tissue depots.
2.To determine the relation between variation in function and morphology of the
adipose tissue depots (SAT, PVAT, OAT or MAT) and clinical metabolic parameters
like blood pressure or BMI of the patients.
3.To determine the relation between variation in function and morphology
between the adipose tissue depots (SAT, PVAT, OAT or MAT) and systemic levels
of adipocytokines measured in the peripheral circulation of the patients.
Study design
Observational cross sectional study
Study burden and risks
For the ADIPOSE -II study patients will be recruited that are allocated to open
abdominal surgery as treatment for an abdominal aortic aneurysm or occlusive
atherosclerosis. Before surgery, patients will undergo an abdominal CT scan and
a visit to the pre operative screening outward clinic which is part of their
treatment.
Regarding the ADIPOSE II study, patients will be asked one blood draw, to
measure biochemical values which are used for inclusion criteria as well as
baseline criteria. Furthermore, patients that meet the inclusion criteria will
be asked to pay one additional visit to the hospital for non invasive physical
measurements and the blood draw.
Participants do not directly benefit from study participation. The scientific
value, however, is considerable. After the study is ended (last participant,
last measurement), participants can choose to receive an overview of some of
their metabolic parameters, in order to optimise their future cardiovascular
disease risk management.
Heidelberglaan 100
3854CX Utrecht
NL
Heidelberglaan 100
3854CX Utrecht
NL
Listed location countries
Age
Inclusion criteria
1.Written and signed informed consent.
2.Male or female (postmenopausal) patients
3.Indicated for elective abdominal aortic surgery in the University Medical Center Utrecht
Exclusion criteria
1.Thyroid disease (TSH > 5 mU/L with clinical symptoms of hypothyroidism)
2.Hepatic disease (ASAT or ALAT > 2 times the upper limit of normal)
3.History of malignancy (in the last 2 years)
4.Use of thiazolidinediones (TZD)
5.Use of immune suppressive medication (equivalent of prednisolon >= 10 mg /day)
6.History of liposuction
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL32757.041.10 |