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| Name | Class |
|---|---|
| Ministry of Health, France | OTHER_GOV |
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Gitelman syndrome is a salt wasting tubulopathy caused by mutations in the SLC12A3 gene coding for the thiazide sensitive sodium chloride cotransporter. This disease mimics the chronic treatment with thiazide diuretics and is characterized by renal hypokalemia, low to normal blood pressure, hypocalciuria and hypomagnesemia. The purpose of this study is to determine whether the heterozygous carriers present the metabolic risks and/or the benefits of this disease.
Gitelman syndrome (GS), is an autosomal recessive salt wasting tubulopathy caused mainly by loss of function mutations in the SLC12A3 gene coding for the thiazide sensitive sodium-chloride cotransporter (NCC). Thus, GS mimics a chronic treatment with high doses of thiazide diuretics. NCC is expressed in the distal convoluted tubule, which is responsible for 7% of NaCl reabsorption. GS is the more frequent hereditary tubulopathie with estimated prevalence of 1/40000, which implicates that 1% of general population are heterozygous carriers (600 000 in France). Previous publications suggest that the apparently asymptomatic heterozygous carriers could present some clinical traits of GS or chronic thiazide treatment. These including: beneficial aspects (low blood pressure, low urinary calcium excretions) or metabolic risks (hypokalemia, insulin resistance). Nevertheless, these studies do not evaluate all the aspects and blood pressure was evaluated once in hospital setting. This study aims to compare home monitoring blood pressure; salt balance; potassium, glucose lipid and mineral metabolism and vascular function in 80 heterozygous carriers, 80 GS patients and 80 controls persons (without mutations in SLC12A3 gene).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| study's population | Other |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Samplings of blood | Procedure |
| ||
| Sampling of urine |
| Measure | Description | Time Frame |
|---|---|---|
| Systolic blood pressure evaluated by self-measurement | self-measurement at home, 3 times a day during 3 consecutive days | 3 days |
| Measure | Description | Time Frame |
|---|---|---|
| Salt balance | Blood renin and aldosterone measurements, 24h urinary sodium and aldosterone excretion | 1 day |
| Potassium metabolism | Dietary intake, blood potassium and 24 h urinary potassium excretion |
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Gitelman syndrome patients, relatives carrying heterozygous mutations and relatives or healthy voluntarees without mutations.
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| Name | Affiliation | Role |
|---|---|---|
| Rosa Vargas-Poussou, MD, PhD | Departement of Genetics. Assistance Publique Hôpitaux de Paris,Hôpital Européen Georges Pompidou. | Principal Investigator |
| Anne Blanchard, MD, PhD | Clinical Research Center. Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou. Paris, France | Study Director |
| Marie Essig, MD, PhD | Departement of Nephrology. Centre Hospitalier Universitaire. Limoges, France | Study Chair |
| Jean Philippe Haymann, MD, PhD | Department of Functional Investigations. Assistance Publique Hôpitaux de Paris, Hôpital Tenon, Paris, France | Study Chair |
| Ivan Tack, MD, PhD | Department of Functional Investigations. Centre Hospitalier Universitaire, Hôpital de Rangueil. Toulouse, France | Study Chair |
| Laurence DUBOURG, MD, PhD | Department of Functional Investigations. Hospices Civils de Lyon, Hôpital Edouard Herriot. Lyon, France | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nephrology Department. Centre Hospitalier Universitaire, Hôpital Dupuytren | Limoges | 87042 Limoges cedex | France | |||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 15198479 | Background | Tago N, Kokubo Y, Inamoto N, Naraba H, Tomoike H, Iwai N. A high prevalence of Gitelman's syndrome mutations in Japanese. Hypertens Res. 2004 May;27(5):327-31. doi: 10.1291/hypres.27.327. | |
| 17981812 | Background | Fava C, Montagnana M, Rosberg L, Burri P, Almgren P, Jonsson A, Wanby P, Lippi G, Minuz P, Hulthen LU, Aurell M, Melander O. Subjects heterozygous for genetic loss of function of the thiazide-sensitive cotransporter have reduced blood pressure. Hum Mol Genet. 2008 Feb 1;17(3):413-8. doi: 10.1093/hmg/ddm318. Epub 2007 Nov 1. |
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|
| Measure of the blood pressure | Procedure |
|
| glycemia test | Procedure |
|
| 1 day |
| Glucose and lipide metabolism | BMI, blood glucose, insulin, cholesterol, LDL, HDL and triglycerides. | 1 day |
| Oral glucose tolerance test | 1 day |
| Mineral metabolism | Blood and urinary calcium, magnesium and phosphate. bone remodeling markers | 1 day |
| Renal fonction | Estimated GFR, proteinuria and albuminuria | 1 day |
| Vascular fonction evaluation | Pulse wave analysis and central blood pressure. Blood and urinary vascular fonction markers | 1 day |
| Department of Functional Investigations. Hospices Civils de Lyon, Hôpital Edouard Herriot. |
| Lyon |
| 69437 Lyon |
| France |
| Department of Functional Investigations. Assistance Publique Hôpitaux de Paris, Hôpital Tenon | Paris | 75020 | France |
| Clinical Research Center. Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou. | Paris | 75908 | France |
| Department of Functional Investigations. Centre Hospitalier Universitaire, Hôpital de Rangueil. | Toulouse | 31059 TOULOUSE cedex 9 | France |
| 18391953 | Background | Ji W, Foo JN, O'Roak BJ, Zhao H, Larson MG, Simon DB, Newton-Cheh C, State MW, Levy D, Lifton RP. Rare independent mutations in renal salt handling genes contribute to blood pressure variation. Nat Genet. 2008 May;40(5):592-599. doi: 10.1038/ng.118. Epub 2008 Apr 6. |
| 19033254 | Background | Hsu YJ, Yang SS, Chu NF, Sytwu HK, Cheng CJ, Lin SH. Heterozygous mutations of the sodium chloride cotransporter in Chinese children: prevalence and association with blood pressure. Nephrol Dial Transplant. 2009 Apr;24(4):1170-5. doi: 10.1093/ndt/gfn619. Epub 2008 Nov 25. |
| 23392128 | Background | Ren H, Qin L, Wang W, Ma J, Zhang W, Shen PY, Shi H, Li X, Chen N. Abnormal glucose metabolism and insulin sensitivity in Chinese patients with Gitelman syndrome. Am J Nephrol. 2013;37(2):152-7. doi: 10.1159/000346708. Epub 2013 Jan 31. |
| 11408395 | Background | Cruz DN, Simon DB, Nelson-Williams C, Farhi A, Finberg K, Burleson L, Gill JR, Lifton RP. Mutations in the Na-Cl cotransporter reduce blood pressure in humans. Hypertension. 2001 Jun;37(6):1458-64. doi: 10.1161/01.hyp.37.6.1458. |
| ID | Term |
|---|---|
| D007008 | Hypokalemia |
| ID | Term |
|---|---|
| D014883 | Water-Electrolyte Imbalance |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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