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NCT Number: NCT06912048

Understanding Individual Variability in Neuronal Signal Transmission to Target Organs in Health and Disease

The goal of this clinical trial is to evaluate the influence of parasympathetic transmission from the brain to different metabolic organs. This transmission can be blocked with the muscarinic antagonist atropine.

Participants will undergo an oral glucose tolerance test combined with a double tracer dilution technique either with atropine infusion or placebo.

Healthy individuals and high-risk individuals will be compared to identify possible changes in signaling in high-risk groups. In addition, men and women will be included to take into account possible sex differences.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

This research project aims to investigate to what extent the parasympathetic nervous system is responsible for the transmission of signals from the brain to peripheral organs. Furthermore, the study will investigate sex differences and differences between healthy and high-risk individuals on brain-derived coordination of postprandial signaling for metabolic control.

Therefore, parasympathetic blockade will be introduced by atropine infusion (on one day) versus saline infusion as placebo (on another day) in a randomized fashion. For safety reasons, only the participants will be blinded. Infusion will start 20 minutes before a 75 gram oral glucose tolerance test (oGTT) and last until the end of the 2h oGTT. The oGTT will introduce a postprandial state. Additionally, 1000 mg Paracetamol will be added to the solution to study gastric emptying.

This approach will be combined with a double-tracer dilution technique. Labeled glucose ([6,6-2H]glucose) will be infused 120 minutes before and during the oGTT (120 min) and will be used to address endogenous glucose production. The glucose drink from the oGTT will be enriched with [U-13C6]glucose to compute the glucose appearance rate (Ra). Basal endogenous glucose production will be calculated as well as post-load endogenous glucose production and rates of glucose disappearances (Rd).

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age: at least 18
  • BMI: 20 - 24.9 kg/m2 (for the healthy groups) or more than 28 kg/m2 (for the overweight groups)
  • For women: Hormonal contraception with a single-phase preparation (e.g. Nuvaring)
  • Understanding and voluntarily signing an informed consent form prior to study-related examinations

Exclusion criteria

  • Drug and/or alcohol abuse
  • smoking
  • Taking medication that affects blood sugar or addresses the central and/or autonomic nervous system (e.g. anti-epileptic drugs, beta blockers, dopamine agonists, antidepressants). Taking antihistamines.
  • Pre-existing cardiac conditions
  • Neurological pre-existing conditions
  • Known cardiac arrhythmia
  • Known allergies to ingredients, e.g. paracetamol and atropine
  • Known narrow-angle glaucoma
  • Known hyperthyroidism
  • Known diseases of the urinary tract or prostate
  • Pregnancy or breastfeeding
  • At screening: Hb < 12 g/dl for women and Hb < 14 g/dl for men
  • No consent to be informed about incidentally discovered pathological findings
  • Any (clinical) condition which, in the opinion of the physician, could jeopardize the safety of the
  • or would jeopardize the scientific success.
  • Liver dysfunction
  • Renal insufficiency

Treatment and study plan

Oral glucose tolerance test with double-tracer dilution and atropine infusion

Other

Subjects will undergo a 75 g oGTT (180 min) combined with a double tracer dilution. The double-tracer dilution technique will be used to quantify endogenous glucose production, glucose appearance and disappearance rate. [6,6-2H]glucose will be infused for a total of 300 minutes, while the infusion will start 120 minutes prior the oGTT and will last until the end of the oGTT. Atropine infusion will be administered 20 minutes before the start of the oGTT. The drink consumed at time point 0 min contains 75 gram glucose, enriched with [U-13C6]-glucose.

Oral glucose tolerance test with double-tracer dilution and saline infusion (placebo)

Other

Subjects will undergo a 75 g oGTT (180 min) combined with a double tracer dilution. The double-tracer dilution technique will be used to quantify endogenous glucose production, glucose appearance and disappearance rate. [6,6-2H]glucose will be infused for a total of 300 minutes, while the infusion will start 120 minutes prior the oGTT and will last until the end of the oGTT. Saline infusion will be administered 20 minutes before the start of the oGTT. The drink consumed at time point 0 min contains 75 gram glucose, enriched with [U-13C6]-glucose.

Primary outcomes

  1. Glucose tolerance

    Time frame: 120 minutes

    Effect of parasympathetic blockade with atropine versus placebo on glucose tolerance assessed as area under the glucose curve (0-120 minutes) and glucose levels at timepoint 120 minutes during the 75 g oral glucose tolerance test.

  2. Insulin Sensitivity

    Time frame: 120 minutes

    Effect of parasympathetic blockade with atropine versus placebo on insulin sensitivity assessed from glucose and insulin measurements during the 75 g oral glucose tolerance test.

  3. Insulin Secretion

    Time frame: 180 minutes

    Effect of parasympathetic blockade with atropine versus placebo on insulin secretion assessed from glucose and insulin/C-peptide measurements during the 75 g oral glucose tolerance test.

Secondary outcomes

  1. Lipolysis

    Time frame: 120 minutes

    Effect of parasympathetic blockade with atropine versus placebo on the suppression of lipolysis during a 75 g oral glucose tolerance test.

  2. Gastric emptying

    Time frame: 120 minutes

    Effect of parasympathetic blockade with atropine versus placebo on gastric emptying during the 75 g oral glucose tolerance test.

  3. Amino Acid Metabolism

    Time frame: 120 minutes

    Effect of parasympathetic blockade with atropine versus placebo on amino acid metabolism assessed by amino acid measurements during the 75 g oral glucose tolerance test.

  4. Bile acid metabolism

    Time frame: 120 minutes

    Effect of parasympathetic blockade with atropine versus placebo on bile acid metabolism assessed by bile acid measurements during the 75 g oral glucose tolerance test.

  5. Substrate oxidation

    Time frame: 230 Minutes

    Effect of parasympathetic blockade with atropine versus placebo on substrate oxidation assessed by indirect calorimetry at timepoints -110 Minutes, 30 Minutes, 60 Minutes and 120 Minutes during the 75 g oral glucose tolerance test.

  6. Incretin secretion

    Time frame: 120 minutes

    Effect of parasympathetic blockade with atropine versus placebo on incretin secretion during the 75 g oral glucose tolerance test.

  7. Sex differences

    Time frame: 180 minutes

    Explore sex differences in the effect of parasympathetic blockade with atropine versus placebo in the mentioned outcome measures.

  8. Autonomic nervous system

    Time frame: 180 minutes

    Effect of parasympathetic blockade with atropine versus placebo on the autonomic nervous system assessed by heart rate variability during the 75 g oral glucose tolerance test.

  9. Blood coagulation parameters

    Time frame: 120 Minutes

    Influence of of parasympathetic blockade with atropine versus placebo on blood coagulation parameters. This is assessed through global coagulation tests and single coagulation factors.

Other outcomes

  1. Circulating peptides

    Time frame: 120 minutes

    Effect of parasympathetic blockade with atropine versus placebo on circulating proteins/peptides during the 75 g oral glucose tolerance test.

  2. Lipids and lipoproteins

    Time frame: 120 minutes

    Effect of parasympathetic blockade with atropine versus placebo on lipids and lipoproteins assessed by lipid measurements during the 75 g oral glucose tolerance test.

  3. Metabolites

    Time frame: 120 minutes

    Effect of parasympathetic blockade with atropine versus placebo on circulating metabolites during the 75 g oral glucose tolerance test.

  4. Immune cell composition

    Time frame: 120 minutes

    Effect of parasympathetic blockade with atropine versus placebo on immune cell composition assessed by flow cytometry during the 75 g oral glucose tolerance test.

  5. Insulin clearance

    Time frame: 120 minutes

    Effect of parasympathetic blockade with atropine versus placebo on insulin clearance assessed from insulin and C-peptide measurements during the 75 g oral glucose tolerance test.

  6. Metabolic flexibility

    Time frame: 180 minutes

    Effect of parasympathetic blockade with atropine versus placebo on metabolic flexibility assessed by the change in respiratory quotient during the 75 g oral glucose tolerance test.

Study contacts

Contact information is provided by the study sponsor or research team.

Andrea Geissler

CONTACT

[email protected]

Martin Heni, MD

CONTACT

[email protected]

+4973150044505

Sponsors and collaborators

Lead sponsor

University of Ulm

Other

Registry information

Acronym: CPB_Atropine

Important dates

Study start
2025
Primary completion
2027
Study completion
2027
First posted
Apr 4, 2025
Registry last updated
Jul 10, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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