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Trial registered on ANZCTR
Registration number
ACTRN12613000127707
Ethics application status
Approved
Date submitted
27/01/2013
Date registered
1/02/2013
Date last updated
11/02/2021
Date data sharing statement initially provided
11/02/2021
Date results provided
11/02/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Salt and its effects on endothelial function in patients with type two diabetes
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Scientific title
Effect of salt supplementation on sympathetic nervous system activity and endothelial function in people with type two diabetes
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Secondary ID [1]
281848
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Nil
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Universal Trial Number (UTN)
U1111-1138-9513
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Trial acronym
NIl
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Diabetes
288207
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Endothelial Function
288208
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Sympathetic nervous system activity
288209
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Condition category
Condition code
Metabolic and Endocrine
288576
288576
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0
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Diabetes
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Cardiovascular
288623
288623
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Neurological
288624
288624
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Salt loading (Slow Sodium, NaCl at a dose of 100mmol/24h in 3 divided doses) or placebo to be taken daily for 3 weeks each. Slow release salt capsules manufactured by Thompson’s compounding pharmacy.
As this is a cross over study, there will be a three week washout period between both treatment arms.
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Intervention code [1]
286407
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Treatment: Other
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Comparator / control treatment
Identical placebo tablets will be manufactured by Thompson’s Compounding Pharmacy in Bulleen, Victoria. These will be identical in appearance, taste and size but will not contain any salt (NaCl).
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Patients with Type 2 diabetes (Cases) with habitual salt intake in the lowest tertile (<150mmol/24h), have increased baseline Sympathetic Nervous System (SNS) activity and increased endothelial dysfunction compared to Controls.
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Assessment method [1]
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Timepoint [1]
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During baseline visit, week three and week nine of the trial, the SNS will be measured by muscle sympathetic Muscle Sympathetic Nerve Activity (MSNA) and by Pulse Amplitude Tonometry (EndoPAT). For endothelial dysfunction, this will be measured at baseline and the start of week three, week six and week nine.
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Primary outcome [2]
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Salt loading (100mmol/24h over 3 weeks) will reduce SNS activity and improve endothelial function in Cases, not Controls.
a.Reduction in SNS activity will be measured by Muscle Sympathetic Nerve Activity (MSNA).
b.Improved endothelial function will be measured by Pulse Amplitude Tonometry (EndoPAT).
c.Improved endothelial function will be measured by endothelial microparticles (EMP).
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Assessment method [2]
288731
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Timepoint [2]
288731
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Nine weeks
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Secondary outcome [1]
300855
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NIl
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Assessment method [1]
300855
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Timepoint [1]
300855
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NIl
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Eligibility
Key inclusion criteria
Blood Pressure <150/80
Body Mass Index matched
2 out of 3 24 hour urine collections <150mmol/24h
35 patients will be recruited into the Type Two Diabetes arm and 35 non-diabetic patients will be recruited into the control arm.
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Minimum age
50
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Other active significant medical problems, including clinical autonomic neuropathy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
This is a randomised double blind, controlled, cross-over study with the intervention being salt loading (100mmol/24h) versus placebo in patients with T2DM and controls (normotensive but age, sex and BMI matched). The pharmacy department will be responsible for allocating tablets which will be in a non-identified envelope to patient or pharmacy department.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Crossover
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The statistical power for this study will be based on measurements of endothelial function and SNS. As participants will be their own controls, a sample size of 29 will ensure a power of 90% and a type 1 error to detect an effect on RHI of at least 22% (difference 0.4404) with a standard deviation of 0.5753. Thirty five participants will be recruited to allow for drop outs. A sample size of 21 subjects per treatment arm will have an 80% power to demonstrate a difference in MSNA of 20% or greater (a = 0.05). Hence, allowing for possible procedural failure and participant withdrawal from the study 35 subjects will be recruited. Moreover, treatment effects on MSNA, EndoPAT, EMPs will be analysed using a 2-way ANOVA, one between-group factor being cases versus controls and one within-subject factor being salt supplement versus placebo.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
11/02/2013
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Actual
1/08/2013
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Date of last participant enrolment
Anticipated
11/12/2013
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Actual
31/08/2016
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Date of last data collection
Anticipated
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Actual
18/11/2019
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Sample size
Target
70
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Accrual to date
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Final
22
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
504
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Austin Health - Heidelberg Repatriation Hospital - Heidelberg West
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Recruitment postcode(s) [1]
6245
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3081 - Heidelberg West
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Austin Medical Research foundation
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Address [1]
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145 Studley Road, Heidelberg, Victoria 3084
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Dr Elif Ilhan Ekinci, Director of Diabetes
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Address
Department of Endocrinology, Austin Health
Level 2 Centaur Building, Repatriation Campus Heidelberg West, VIC 3081
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
285415
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Professor George Jerums
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Address [1]
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Department of Endocrinology, Austin Health. Level 2 Centaur Building, Repatriation Campus Heidelberg West, VIC 3081
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Country [1]
285415
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Australia
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Other collaborator category [1]
277269
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Other Collaborative groups
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Name [1]
277269
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Baker IDI Heart & Diabetes Institute
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Address [1]
277269
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75 Commercial Road
Melbourne, Victoria 3004
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Country [1]
277269
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288708
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Austin Health Human Research Ethics Committee
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Ethics committee address [1]
288708
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145 Studley road Heidelberg, Victoria 3084
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Ethics committee country [1]
288708
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Australia
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Date submitted for ethics approval [1]
288708
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Approval date [1]
288708
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13/09/2012
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Ethics approval number [1]
288708
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HREC/12/Austin/63
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Summary
Brief summary
A high salt diet is associated with an increased risk of hypertension. By contrast, in patients with type 2 diabetes, a low salt diet is associated with an increased risk for cardiovascular and total mortality. As a low salt intake may increase sympathetic nervous system (SNS) activity, we aim to determine baseline SNS activity and endothelial function in patients with diabetes consuming a habitual low salt diet and determine whether salt loading reduces SNS activity and enhances endothelial function.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Elif Ilhan Ekinci
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Address
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Department of Endocrinology, Austin Health
Level 2 Centaur Building, Repatriation Campus Heidelberg West, VIC 3081
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Country
37370
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Australia
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Phone
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+61 3 94965000
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Sara Baqar
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Address
37371
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Department of Endocrinology, Austin Health
Level 2 Centaur Building, Repatriation Campus Heidelberg West, VIC 3081
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Country
37371
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Australia
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Phone
37371
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+61 3 94965000
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Fax
37371
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Email
37371
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[email protected]
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Contact person for scientific queries
Name
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Elif Ilhan Ekinci
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Address
37372
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Department of Endocrinology, Austin Health
Level 2 Centaur Building, Repatriation Campus Heidelberg West, VIC 3081
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Country
37372
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Australia
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Phone
37372
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+61 3 94965000
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Fax
37372
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Email
37372
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
All individual participant data after deidentification
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When will data be available (start and end dates)?
Immediately following publication. No end date.
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Available to whom?
Anyone who wishes to access the data
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Available for what types of analyses?
For any purpose
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How or where can data be obtained?
Proposals to be sent to
[email protected]
36 months after publication.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Effect of salt supplementation on sympathetic activity and endothelial function in salt-sensitive type 2 diabetes.
2020
https://dx.doi.org/10.1210/clinem/dgz219
N.B. These documents automatically identified may not have been verified by the study sponsor.
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