Hyperinsulinism, Immune System, Insulin Resistance
Conditions
Keywords
Insulin resistance
Brief summary
This is a two-center proof-of-concept study, ancillary to the MetACTIV study, whose objective is to define immune activation profiles from the data of individuals followed by the Caisse Primaire d'Assurance Maladie du Gard (health insurance fund). The IRACTIV study will include a subset of volunteers from the MetACTIV study for whom a blood sample will be taken as part of the IRACTIV study.
Detailed description
The local health insurance fund regularly offers people who have already had a free health check-up the opportunity to re-do a check-up. This invitation will be made as part of the routine, by mail. People who have participated in the MetACTIV study will be asked to participate in the present IRACTIV study ( they will be sent an information note). That way, up to 30 volunteers who previously participated in the MetACTIV study, including 10 for whom a particular profile has been identified will be recruited again in sequence. On the day of consultation at the Gard health insurance fund, consent will be collected from subjects who have agreed to participate. The participation of the volunteers will be reduced to this single visit and 16 mL of blood will be collected on EDTA for the purpose of this study. As in the previous MetACTIV study, this blood will be transported to the Biological Resource Center at Nîmes University Hospital. From this blood, the plasma will be frozen and stored at -80°C for subsequent determination of insulin levels under the same conditions as for the MetACTIV study. Peripheral blood mononuclear cells will be frozen and, later, cultured at the Institute of Human Genetics in complete medium for 48 hours. The effect of the supernatants of these cultures on Akt phosphorylation in HepG2 cells exposed to 10nM of insulin will then be quantified by two different techniques (Western Blot and ELISA). This effect will be expressed as a percentage of inhibition compared to the phosphorylation of Akt induced by insulin alone. The insulin slope between the measurement performed in the MetACTIV study and this IRACTIV study will also be calculated and compared to the peripheral blood mononuclear cells ability to induce insulin resistance in vitro.
Interventions
DIAGNOSTIC_TESTBlood test
Sixteen mL of blood will be collected on EDTA for the purpose of this study
Sponsors
Caisse Primaire d'Assurance Maladie du Gard
Centre Hospitalier Universitaire de Nīmes
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
This is a two-center proof-of-concept study, ancillary to the MetACTIV study, whose objective is to define immune activation profiles from the data of individuals followed by the Gard health insurance fund. The IRACTIV study will include a subset of volunteers from the MetACTIV study for whom a blood sample will be taken as part of the IRACTIV study. In order to study the evolution of insulin levels in volunteers, we need to be able to ensure a longitudinal analysis, which requires a link with the MetACTIV study data for the volunteers included in the IRACTIV study.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Individuals who participated in the MetACTIV study. * Profile 2 subgroup-specific inclusion criteria: * MetACTIV study individual with a Profile 2. * Persons who have given free informed consent. * Persons who have signed the consent form. * Persons affiliated to or benefiting from a health insurance plan. * Adults (≥18 years of age).
Exclusion criteria
* Persons participating in Category 1 research involving human subjects * Persons in an exclusion period as determined by another study. * Persons under court protection, guardianship or trusteeship. * Persons who are incapable of giving consent. * Persons for whom it is impossible to give clear information. * Pregnant, parturient or breastfeeding woman.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fasting blood glucose | Day 0 | Fasting blood glucose will be measured during a routine health evaluation and measured in mM/L. |
| End-of-study insulinemia | Month 18 | The amount of insulin in the blood of patients will be measured during a routine health evaluation and measured in µU/L. |
| Effect of peripheral blood mononuclear cell supernatant on intensity of the signal induced by insulin in hepatocytes. | Hour 48 | Peripheral blood mononuclear cells are isolated on a Ficoll gradient and frozen. These frozen peripheral blood mononuclear cells will be sent to the Institute of Human Genetics for culture and supernatants will be recovered after 48 hours. The effect of these supernatants on insulin signaling will then be tested. To do so, they will be added or not to cultured HepG2 cells stimulated 24 hours later by 10nM insulin. After stimulation, HepG2 cells will be lysed and their total Akt and phosphorylated Akt content measured by ELISA and Western Blot. The proportion of phosphorylated Akt in HepG2 cells exposed to peripheral blood mononuclear cells supernatant will be compared with the proportion of phosphorylated Akt in HepG2 cells not exposed to peripheral blood mononuclear cells supernatant and expressed as the percentage of insulin signaling inhibition induced by the peripheral blood mononuclear cells supernatant. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| A. Percentage inhibition of Akt phosphorylation in Profile 2 patients compared with other immune profiles. | Hour 48 | The decrease in signal intensity induced in hepatocytes by insulin induced by peripheral blood mononuclear cell supernatant from volunteers with Profile 2 will be compared to the decrease in this intensity induced by peripheral blood mononuclear cell supernatant from volunteers with another immune activation Profile. Measured as a percentage. |
| B. Increase in insulinemia over time in Profile 2 patients compared with other immune profiles. | Month 18 | Insulinemia in Profile 2 volunteers, measured in µU/mL, will be compared with that of other immune profiles. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Systolic blood pressure in Profile 2 patients | Day 0 | In mmHg |
| Diastolic blood pressure in Profile 2 patients | Day 0 | In mmHg |
| High-density lipoproteins in Profile 2 patients | Day 0 | mM/L |
| Age of Profile 2 patients | Day 0 | In years |
| Triglycerides in Profile 2 patients | Day 0 | mM/L |
| Hemoglobin A1c in Profile 2 patients | Day 0 | mM/L |
| Low-density lipoproteins in Profile 2 patients | Day 0 | mM/L |
| Weight of profile 2 patients | Day 0 | In kg |
| Gender of Profile 2 patients | Day 0 | male / female |
| Waist measurement of Profile 2 patients | Day 0 | In cm |
| Hip circumference of Profile 2 patients | Day 0 | In cm |
Countries
France
Outcome results
None listed