Genomic and Metabolomic Markers Reflecting the Complications of Hypercortisolism

Status: Recruiting
Location: See location...
Intervention Type: Other, Biological
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

The excess of glucocorticoid, whether endogenous or exogenous, results in Cushing's syndrome, associating a particular distribution of fats (accumulation in the face and trunk), a decrease in the thickness of the muscles, diabetes, hypertension or osteoporosis. The level of effects obviously depends on the extent of the excess glucocorticoids, and on the duration of this exposure. However, the manifestations of Cushing's syndrome also depend very much on the sensitivity of each individual to glucocorticoids for each of these conditions. Indeed, for the same duration and level of exposure, some will have diabetes only, others only osteoporosis, others hypertension, while still others will have these three complications. Today the investigators are unable to specify individual risks. For example, will someone develop diabetes when exposed to glucocorticoids? Or on the contrary will blood sugar level remain normal? The same question arises for hypertension and osteoporosis. The deficiency of glucocorticoid, called adrenal insufficiency, causes fatigue and discomfort. The intensity of the signs depends on the depth of the insufficiency. Here again, there is a large variability in the sensitivity of each individual to glucocorticoids: when one substitutes for adrenal insufficiency at a given dose, some individuals will feel well, while others will still remain tired. The investigators are unable to specify participant's individual requirement. The aim of this research is to identify factors that determine individual sensitivity to glucocorticoids. For excess glucocorticoids, the investigators are looking for specific molecular markers for each type of glucocorticoid complication: markers for corticosteroid-induced diabetes, corticosteroid-induced hypertension, or corticosteroid-induced osteoporosis. For adrenal insufficiency, they are also looking for substitute good balance markers for adrenal insufficiency. To answer the research question, it is planned to include 400 subjects exposed to glucocorticoid excess (by excess of endogenous glucocorticoids or induced by corticosteroid therapy) and 100 subjects with adrenal insufficiency. It is also planned to include 100 subjects without excess glucocorticoids but presenting either diabetes, hypertension or osteoporosis; these subjects will constitute a control group. The investigators will perform a very large number of measurements in small amounts of blood and urine, in order to identify a few marks specifically associated with each of the complications. This research will identify, for every person exposed to glucocorticoids, the probability of developping some complications, and reversely the probability of being exempt from other complications.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• an endogenous hypercortisolism (group 1)

• a disease justifying the next start of glucocorticoid therapy (group 2)

• chronic adrenal insufficiency (group 3)

• subjects with either diabetes, hypertension or osteoporosis, but without glucocorticoid excess (control group)

• patients will have to be affiliated to a social security scheme

• patients should be able to understand the study and able to express their consent

Locations
Other Locations
France
Hôpital Cochin
RECRUITING
Paris
Contact Information
Primary
Guillaume ASSIE, PhD
guillaume.assie@aphp.fr
+ 33 1 58 41 18 40
Backup
Christelle AUGER
christelle.auger@aphp.fr
+ 33 1 58 41 11 86
Time Frame
Start Date: 2023-08-01
Estimated Completion Date: 2026-12
Participants
Target number of participants: 540
Treatments
Experimental: Excess of endogenous glucoglucocorticoids (group 1)
v
Experimental: Exogenous hypercortisolisms (group 2)
a disease justifying the up-coming start of a glucocorticoid therapy
Experimental: Adrenal insufficiency (group 3)
chronic adrenal insufficiency
Other: Control (group 4)
without glucocorticoid excess
Sponsors
Leads: Assistance Publique - Hôpitaux de Paris
Collaborators: European Union's Horizon 2020 research and innovation programme under grant agreement No 633983

This content was sourced from clinicaltrials.gov