HypertensionPhase 2NCT00434499
Effect of EGCG on the Body's Response to Insulin
A Phase 2 study testing EGCG in people with Hypertension and Obesity, run by University of Maryland, Baltimore at 1 site in United States.
Trial summary
This study will examine whether epigallocatechin gallate (EGCG), a major component of green tea, affects how the body responds to insulin in healthy and obese people. Insulin is not as effective in people who are overweight, have high blood pressure or diabetes. This condition is known as insulin resistance. Read more about this study
- Who is it for?
- Ages 21 to 65 yearsHealthy volunteers can take part
- Conditions the study is for
- Hypertension, Obesity, Type 2 Diabetes
- What is being tested?
- EGCG
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 0 participants
- Where
- 1 siteUnited States
- Study dates
- Feb 2007to Dec 2015
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 21 to 65 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- HEALTHY SUBJECTS:
- Men and women in good general health with no significant underlying illnesses who are between the ages of 21-65 years of age with HbA(1C) less than 6.5%, fasting blood glucose less than 100 mg/dL, blood pressure less than 120/80, and BMI between 20-25 kg/m(2). Subjects should have never smoked tobacco or not smoked within the previous year.
- OBESE SUBJECTS:
- Men and women in good general health with no significant underlying illnesses except obesity who are between the ages of 21-65 years of age with HbA(1C) less than 6.5%, fasting blood glucose less than 110 mg/dl, blood pressure less than 140/90, and BMI between 30-40 kg/m(2).
Who cannot join
- ALL SUBJECTS:
- Subjects will be excluded from our study if they are pregnant , breastfeeding or if they plan pregnancy prior to the end of the study.
- In addition, subjects will be excluded if their age is greater than 65 yrs, BMI greater than or equal to 40 kg/m(2), or have liver disease (including liver transaminase levels greater than twice the upper limit of normal), pulmonary disease, renal insufficiency (serum creatinine greater than 2.0 mg/dl), coronary heart disease, heart failure (New York Heart Association heart failure Class III or IV), peripheral vascular disease, coagulopathy, major depressive disorder, actively smoking or used tobacco within the last year, history of cancer, in treatment for any form of cancer, positive tests for HIV, hepatitis B or C, or take systemic corticosteroids, thiazolidinediones (within 3 months), insulin, or anticoagulants, use food supplements that cannot be discontinued, regular intake of 8 or more cups of tea per week within 3 months prior to study entry, regular alcoholic beverage intake of more than two drinks per day (a drink corresponds to approximately 12 ounces of beer, 4 ounces of table wine, and between 1 and 1.5 ounces of 80-proof spirits), poor compliance during run-in period or regular use of medications that affect insulin sensitivity, blood pressure or vascular function and that cannot be discontinued.
- In addition, history of any other medical disease, laboratory abnormalities, or psychological conditions that would make the subject (based upon the principal investigator's judgment) unsuitable for study enrollment.
- Subjects with known hypersensitivity to octafluoropropane, recent eye surgery, or with known cardiac shunts will also be excluded from participating because of potential adverse effects from microbubble contrast agent.
- Subjects will be excluded if they are unable to give informed consent for all procedures.
- Currently, type 2 diabetes is not rare in children, however children are excluded from this study because children do not typically take EGCG and do not typically have hypertension or type 2 diabetes mellitus.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: An Exploratory Study to Evaluate the Ability of Epigallocatechin Gallate to Simultaneously Improve Metabolic and Cardiovascular Actions of Insulin in Healthy and Obese Subjects
This study will examine whether epigallocatechin gallate (EGCG), a major component of green tea, affects how the body responds to insulin in healthy and obese people. Insulin is not as effective in people who are overweight, have high blood pressure or diabetes. This condition is known as insulin resistance. Laboratory studies suggest that green tea or EGCG treatment lowers blood pressure, lowers blood sugar and increases blood flow. This study will see if EGCG improves insulin resistance or insulin's effects on blood flow in people with insulin resistance.
Healthy normal weight or overweight people between 21 and 65 years of age may be eligible for this study. Participants are randomly assigned to take EGCG or a placebo ( inactive dummy pill ) in two 4-week treatment phases with a 2-week period of no study medication before each treatment phase. After the first 4-week treatment, patients on placebo are switched to EGCG and those on EGCG are switched to placebo. In addition to treatment, participants undergo the following procedures during the study period:
- Screening, including medical history, physical examination and blood and urine tests, and finger-stick blood sugar measurement for patients with diabetes
- Complete a dietary and physical activity questionnaire and consult with a dietitian
- Blood and urine tests
- At-home and clinic blood pressure monitoring
- Glucose clamp test to measure how the body responds to insulin. This test is done three times during the study. A needle is placed in a vein in each of the subject's arms, one for sampling blood and the other for infusing insulin, glucose and potassium. Glucose and insulin levels, electrolytes, lipids, fatty acids, cytokines and epicatechin are measured.
- Forearm blood flow measurement with microbubbles and ultrasound. Before beginning the glucose clamp test, a test of how well the blood vessels relax is done. A device that measures the size of the artery in the upper arm is placed above the elbow. Blood flow in the muscle of the forearm is measured by ultrasound using a small infusion through a vein of microbubble contrast agent consisting of gas-filled bubbles the size of red blood cells. The contrast agent is infused over a 7- to 9-minute period at the beginning of the glucose clamp test and again 2 hours after the beginning of the test.
Read the detailed description
Green tea is a functional food whose consumption is associated with improved cardiovascular morbidity and mortality in several large epidemiological studies. One third of the solids in green tea are composed of the bioactive polyphenol epigallocatechin 3-gallate (EGCG). Studies in both cell- and animal-based models (from our lab and elsewhere) suggest that EGCG may mimic and/or augment beneficial metabolic, vascular, and anti-inflammatory actions of insulin. Indeed, we have recently shown that 3-week EGCG therapy of SHR rats (genetic model of hypertension with features of human metabolic syndrome including insulin resistance, hyperinsulinemia, endothelial dysfunction, and overweight) lowers blood pressure, improves endothelial dysfunction, increases insulin sensitivity, and raises adiponectin levels nearly as effectively as treatment with the conventional ACE-inhibitor enalapril. Obesity, type 2 diabetes, and hypertension are all important interrelated public health problems that are characterized by reciprocal relationships between insulin resistance and endothelial dysfunction. Thus, therapies for these diseases that improve insulin resistance often simultaneously improve endothelial function and vice versa. Based on results from cellular, physiological, and epidemiological studies, we hypothesize that oral EGCG administration will simultaneously ameliorate insulin resistance and lower blood pressure in human subjects with obesity. To test these hypotheses, we will conduct a randomized, placebo-controlled, double-blind, cross-over study to evaluate potential beneficial effects of EGCG to modulate insulin sensitivity, blood pressure, vascular function, and inflammatory markers in two groups of subjects (lean healthy controls, obesity). After a 2-week EGCG-free run-in period, each subject will be randomized to receive EGCG or placebo capsules (400 mg p.o. B.I.D.) for 4 weeks. This will be followed by a 2-week EGCG-free washout period after which subjects will cross-over to the other treatment arm. At baseline, and after each 4-week treatment period, we will assess insulin sensitivity (hyperinsulinemic isoglycemic glucose clamp technique) and vascular function. Regarding vascular function, we will measure basal and insulin-stimulated brachial artery blood flow (large conduit artery assessed by Doppler ultrasound) as well as capillary recruitment in forearm skeletal muscle (small nutritive arterioles assessed by ultrasound with microbubble contrast). Blood pressure will be measured weekly in the UMB GCRC throughout the duration of the study. EGCG pharmacokinetics will be measured at the beginning of each glucose clamp study day after oral administration of a single dose of EGCG or placebo. Finally, various plasma markers of inflammation will be measured at baseline and at the end of each treatment arm to evaluate potential changes that may be related to improvements in metabolic and/or vascular function. This study will explore whether EGCG, a single compound thought to be a major bioactive component of green tea, is effective at improving insulin resistance and lowering blood pressure in subjects with obesity. Results from this study may have important implications for understanding potential health benefits of functional foods that contain bioactive polyphenols including green tea, dark chocolate, and red wine.
- Conditions
- Hypertension, Obesity, Type 2 Diabetes, Insulin Resistance
- Being tested
- EGCG
- Keywords
- Green Tea, Insulin Resistance, Endothelial Dysfunction, Nitric Oxide, Inflammation, Obesity, Overweight, Diabetes Type 2, High Blood Pressure, Healthy Volunteer, HV
- Medical subject headings
- Hypertension, Obesity, Diabetes Mellitus, Type 2, Insulin Resistance, Inflammation, Overweight
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
EGCGDrug
EGCG 400 mg by mouth twice/daily for 4 weeks duration.
| Study group | Role | What they receive |
|---|---|---|
| placebo first | Active comparator | placebo first then crossover to EGCG Receives: Drug: EGCG |
| EGCG first | Active comparator | EGCG first then crossover to placebo Receives: Drug: EGCG |
What is being measured
The primary outcome is the main question the study is designed to answer.
Improvement in insulin resistance
measurements of insulin resistance prior to study drug, after 4 weeks of EGCG or placebo and at end of study
Measured: 14 weeks
Secondary outcomes (1)
Improvement in endothelial dysfunction
measurements of endothelial function prior to study drug, after 4 weeks of EGCG or placebo and at end of study
Measured: 14 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Feb 2007 (estimated)
- Study startFeb 2007
- Primary completionDec 2015
- Study completionDec 2015
Why it stopped: Not funded
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for HypertensionStudies of the same condition, open and under way.
- More trials run by University of Maryland, BaltimoreThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 0 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Maryland, Baltimore
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Kashif Munir, University of Maryland, Baltimore
- Investigators
- Kashif Munir, MD, Principal investigator, University of Maryland
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00434499
- Sponsor's protocol ID
- HP-00048859
- Status last verified
- Feb 2022
- First submitted
- 10 Feb 2007
- Last updated
- 4 Mar 2022
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Jemal A, Ward E, Hao Y, Thun M. Trends in the leading causes of death in the United States, 1970-2002. JAMA. 2005 Sep 14;294(10):1255-9. doi: 10.1001/jama.294.10.1255.
PubMed 16160134Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA. 1999 Oct 27;282(16):1523-9. doi: 10.1001/jama.282.16.1523.
PubMed 10546691Fox CS, Coady S, Sorlie PD, Levy D, Meigs JB, D'Agostino RB Sr, Wilson PW, Savage PJ. Trends in cardiovascular complications of diabetes. JAMA. 2004 Nov 24;292(20):2495-9. doi: 10.1001/jama.292.20.2495.
PubMed 15562129
Study at a glance
From the registry record, last updated by the sponsor on 4 Mar 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- An Exploratory Study to Evaluate the Ability of Epigallocatechin Gallate to Simultaneously Improve Metabolic and Cardiovascular Actions of Insulin in Healthy and Obese Subjects
- ClinicalTrials.gov ID
- NCT00434499
- Acronym / sponsor ID
- HP-00048859
- Conditions
- Hypertension, Obesity, Type 2 Diabetes, Insulin Resistance
- Keywords
- Green Tea, Insulin Resistance, Endothelial Dysfunction, Nitric Oxide, Inflammation, Obesity, Overweight, Diabetes Type 2
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- WithdrawnReason stopped: Not funded
- Enrolment
- 0 participants (actual)
- Lead sponsor
- University of Maryland, BaltimoreUniversity, hospital or other
- Study start
- Feb 2007
- Primary completion
- Dec 2015 (actual)
- Study completion
- Dec 2015 (actual)
- First posted
- 13 Feb 2007 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will examine whether epigallocatechin gallate (EGCG), a major component of green tea, affects how the body responds to insulin in healthy and obese people. Insulin is not as effective in people who are overweight, have high blood pressure or diabetes. This condition is known as insulin resistance. Laboratory studies suggest that green tea or EGCG treatment lowers blood pressure, lowers blood sugar and increases blood flow. This study will see if EGCG improves insulin resistance or insulin's effects on blood flow in people with insulin resistance.
Healthy normal weight or overweight people between 21 and 65 years of age may be eligible for this study. Participants are randomly assigned to take EGCG or a placebo ( inactive dummy pill ) in two 4-week treatment phases with a 2-week period of no study medication before each treatment phase. After the first 4-week treatment, patients on placebo are switched to EGCG and those on EGCG are switched to placebo. In addition to treatment, participants undergo the following procedures during the study period:
- Screening, including medical history, physical examination and blood and urine tests, and finger-stick blood sugar measurement for patients with diabetes
- Complete a dietary and physical activity questionnaire and consult with a dietitian
- Blood and urine tests
- At-home and clinic blood pressure monitoring
- Glucose clamp test to measure how the body responds to insulin. This test is done three times during the study. A needle is placed in a vein in each of the subject's arms, one for sampling blood and the other for infusing insulin, glucose and potassium. Glucose and insulin levels, electrolytes, lipids, fatty acids, cytokines and epicatechin are measured.
- Forearm blood flow measurement with microbubbles and ultrasound. Before beginning the glucose clamp test, a test of how well the blood vessels relax is done. A device that measures the size of the artery in the upper arm is placed above the elbow. Blood flow in the muscle of the forearm is measured by ultrasound using a small infusion through a vein of microbubble contrast agent consisting of gas-filled bubbles the size of red blood cells. The contrast agent is infused over a 7- to 9-minute period at the beginning of the glucose clamp test and again 2 hours after the beginning of the test.
Detailed description
Green tea is a functional food whose consumption is associated with improved cardiovascular morbidity and mortality in several large epidemiological studies. One third of the solids in green tea are composed of the bioactive polyphenol epigallocatechin 3-gallate (EGCG). Studies in both cell- and animal-based models (from our lab and elsewhere) suggest that EGCG may mimic and/or augment beneficial metabolic, vascular, and anti-inflammatory actions of insulin. Indeed, we have recently shown that 3-week EGCG therapy of SHR rats (genetic model of hypertension with features of human metabolic syndrome including insulin resistance, hyperinsulinemia, endothelial dysfunction, and overweight) lowers blood pressure, improves endothelial dysfunction, increases insulin sensitivity, and raises adiponectin levels nearly as effectively as treatment with the conventional ACE-inhibitor enalapril. Obesity, type 2 diabetes, and hypertension are all important interrelated public health problems that are characterized by reciprocal relationships between insulin resistance and endothelial dysfunction. Thus, therapies for these diseases that improve insulin resistance often simultaneously improve endothelial function and vice versa. Based on results from cellular, physiological, and epidemiological studies, we hypothesize that oral EGCG administration will simultaneously ameliorate insulin resistance and lower blood pressure in human subjects with obesity. To test these hypotheses, we will conduct a randomized, placebo-controlled, double-blind, cross-over study to evaluate potential beneficial effects of EGCG to modulate insulin sensitivity, blood pressure, vascular function, and inflammatory markers in two groups of subjects (lean healthy controls, obesity). After a 2-week EGCG-free run-in period, each subject will be randomized to receive EGCG or placebo capsules (400 mg p.o. B.I.D.) for 4 weeks. This will be followed by a 2-week EGCG-free washout period after which subjects will cross-over to the other treatment arm. At baseline, and after each 4-week treatment period, we will assess insulin sensitivity (hyperinsulinemic isoglycemic glucose clamp technique) and vascular function. Regarding vascular function, we will measure basal and insulin-stimulated brachial artery blood flow (large conduit artery assessed by Doppler ultrasound) as well as capillary recruitment in forearm skeletal muscle (small nutritive arterioles assessed by ultrasound with microbubble contrast). Blood pressure will be measured weekly in the UMB GCRC throughout the duration of the study. EGCG pharmacokinetics will be measured at the beginning of each glucose clamp study day after oral administration of a single dose of EGCG or placebo. Finally, various plasma markers of inflammation will be measured at baseline and at the end of each treatment arm to evaluate potential changes that may be related to improvements in metabolic and/or vascular function. This study will explore whether EGCG, a single compound thought to be a major bioactive component of green tea, is effective at improving insulin resistance and lowering blood pressure in subjects with obesity. Results from this study may have important implications for understanding potential health benefits of functional foods that contain bioactive polyphenols including green tea, dark chocolate, and red wine.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| placebo first | Active comparator | Drug: EGCGplacebo first then crossover to EGCG |
| EGCG first | Active comparator | Drug: EGCGEGCG first then crossover to placebo |
Who may qualify
- Ages
- 21 to 65 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Men and women in good general health with no significant underlying illnesses who are between the ages of 21-65 years of age with HbA(1C) less than 6.5%, fasting blood glucose less than 100 mg/dL, blood pressure less than 120/80, and BMI between 20-25 kg/m(2). Subjects should have never smoked tobacco or not smoked within the previous year.
- Men and women in good general health with no significant underlying illnesses except obesity who are between the ages of 21-65 years of age with HbA(1C) less than 6.5%, fasting blood glucose less than 110 mg/dl, blood pressure less than 140/90, and BMI between 30-40 kg/m(2).
Key exclusion criteria (7 listed)
- Subjects will be excluded from our study if they are pregnant , breastfeeding or if they plan pregnancy prior to the end of the study.
- In addition, subjects will be excluded if their age is greater than 65 yrs, BMI greater than or equal to 40 kg/m(2), or have liver disease (including liver transaminase levels greater than twice the upper limit of normal), pulmonary disease, renal insufficiency (serum creatinine greater than 2.0 mg/dl), coronary heart disease, heart failure (New York Heart Association heart failure Class III or IV), peripheral vascular disease, coagulopathy, major depressive disorder, actively smoking or used tobacco within the last year, history of cancer, in treatment for any form of cancer, positive tests for HIV, hepatitis B or C, or take systemic corticosteroids, thiazolidinediones (within 3 months), insulin, or anticoagulants, use food supplements that cannot be discontinued, regular intake of 8 or more cups of tea per week within 3 months prior to study entry, regular alcoholic beverage intake of more than two drinks per day (a drink corresponds to approximately 12 ounces of beer, 4 ounces of table wine, and between 1 and 1.5 ounces of 80-proof spirits), poor compliance during run-in period or regular use of medications that affect insulin sensitivity, blood pressure or vascular function and that cannot be discontinued.
- In addition, history of any other medical disease, laboratory abnormalities, or psychological conditions that would make the subject (based upon the principal investigator's judgment) unsuitable for study enrollment.
- Subjects with known hypersensitivity to octafluoropropane, recent eye surgery, or with known cardiac shunts will also be excluded from participating because of potential adverse effects from microbubble contrast agent.
- Subjects will be excluded if they are unable to give informed consent for all procedures.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| EGCGEGCG 400 mg by mouth twice/daily for 4 weeks duration. | Drug | EGCG first, placebo first |
Primary outcome
Improvement in insulin resistance
Time frame: 14 weeks
measurements of insulin resistance prior to study drug, after 4 weeks of EGCG or placebo and at end of study
1 secondary outcome
Improvement in endothelial dysfunction
Time frame: 14 weeks
Results and safety
The study was withdrawn before enrolling participants, so there are no results.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Mar 2022.
- Background: PubMed 16160134Jemal A, Ward E, Hao Y, Thun M. Trends in the leading causes of death in the United States, 1970-2002. JAMA. 2005 Sep 14;294(10):1255-9. doi: 10.1001/jama.294.10.1255.
- Background: PubMed 10546691Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA. 1999 Oct 27;282(16):1523-9. doi: 10.1001/jama.282.16.1523.
- Background: PubMed 15562129Fox CS, Coady S, Sorlie PD, Levy D, Meigs JB, D'Agostino RB Sr, Wilson PW, Savage PJ. Trends in cardiovascular complications of diabetes. JAMA. 2004 Nov 24;292(20):2495-9. doi: 10.1001/jama.292.20.2495.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Kashif Munir, MD principal investigator
University of Maryland
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing EGCG in people with Hypertension and Obesity, run by University of Maryland, Baltimore at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: withdrawn, as of the sponsor's last update on 4 Mar 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study was withdrawn before enrolling participants, so there are no results.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Improvement in insulin resistance (time frame: 14 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00434499, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Mar 2022.