Dietary Intervention and Intestinal Microbiota in Non-alcoholic Fatty Liver

NCT ID: NCT01477307

Last Updated: 2017-10-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

20 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-07-01

Study Completion Date

2016-09-15

Brief Summary

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In patients with NAFLD/NASH, changes in liver lipid composition and function tests following a short dietary intervention are associated with changes in gut microbiota

Detailed Description

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Study Hypothesis: In patients with NAFLD/NASH, changes in liver lipid composition and function tests following a short dietary intervention are associated with changes in gut microbiota

Study period:

* Study duration for the participant: 7-10 weeks (1-4 weeks screening period, 3 weeks of intervention + 3 weeks of follow-up)
* Expected study completion date: 30.04.2012 Study type: Single arm before-after study

Number of patients:

20 subjects with obesity and NAFLD / NASH

Main criteria for inclusion:

* Obesity defined as BMI\>30
* Abnormal liver function tests defined as ALT \> 1.5 times the upper limit of normal
* NAFLD present at liver biopsy
* Age \> 18 years, \< 60 years

Main exclusion criteria:

* Inability or unwillingness to give consent
* Parenteral nutrition or other ongoing dietary intervention
* Bulimia
* Other known cause of chronic liver disease, including hepatitis B or C, iron overload,
* Use of substances known to alter intestinal permeability, including alcohol and NSAIDs

Intervention:

The phase 2 Eurodiet® program will be used as standardized hypo-caloric diet during a 3-weeks intervention period. The products are commercially available and prescribed to reach 1000 kcal/day. These products will be offered free of charge.

Primary Objective:

To assess the impact of dietary intervention on the relative abundance of fecal Bacteroidetes (expressed as the bacteroidetes to firmicutes ratio) in patients with obesity, abnormal liver function tests and NAFLD

Secondary Objectives:

1. To compare fecal microbiota from patients with NAFLD or NASH at baseline
2. To assess fecal microbiota changes in patients with NAFLD or NASH after dietary intervention
3. To measure liver fat content at baseline and after dietary intervention
4. To assess changes in liver function tests and ultrasensitive CRP, cytokines and serum LPS in relation to changes in microbiota and liver lipid composition
5. To measure orocecal transit time, an index of intestinal pullulation, at baseline and after dietary intervention in patients with NAFLD or NASH
6. To measure intestinal permeability at baseline and after dietary intervention in patients with NAFLD or NASH
7. To assess body composition changes in relation to changes in microbiota and liver lipid composition

Statistical methods:

Baseline and end-of-treatment changes for both bacterial genders and subspecies will be compared using paired-sample Wilcoxon signed-rank test. ANOVA and paired t-test for comparison of other changes within groups. Pearson or Spearman tests will be used to assess correlations between changes in microbiota and changes in liver fat content, liver function tests, CRP, cytokines and intestinal pullulation and permeability.

Sample size:

20 patients with NAFLD/NASH will be studied before and after dietary intervention.

Assessment of end-points:

Fecal microbiota will be analysed with 454-Flex metagenomics Ultrasensitive CRP and serum LPS changes as compared with baseline Serum cytokines as measured with ELISA Liver fat content and composition will be measured using MR spectroscopy Small intestinal overgrowth and intestinal permeability will be assessed using standard 13C breath tests and polyethyleneglycol absorption test Body mass composition changes will be assessed using bioelectrical impedance analysis

Safety :

All adverse events will be recorded throughout the study, in compliance with GCP ICH E6 and national regulations.

Conditions

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Obesity Non-alcoholic Fatty Liver Disease (NAFLD)

Keywords

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obesity non-alcoholic fatty liver disease

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

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hypocaloric diet

The included patients are assigned to a hypocaloric standardized diet for 3 weeks.

Hypocaloric diet

Intervention Type OTHER

Eurodiet,standardized hypo-caloric diet, during 3 weeks

Interventions

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Hypocaloric diet

Eurodiet,standardized hypo-caloric diet, during 3 weeks

Intervention Type OTHER

Other Intervention Names

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eurodiet 2

Eligibility Criteria

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Inclusion Criteria

Obesity defined as BMI\>30 Abnormal liver function tests defined as ALT \> 1.5 times the upper limit of normal NAFLD present at liver biopsy Age \> 18 years, \< 60 years

Exclusion Criteria

Inability or unwillingness to give consent Bulimia Other known cause of chronic liver disease, including hepatitis B or C, iron overload, Use of substances known to alter intestinal permeability, including alcohol and NSAIDs
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University Hospital, Geneva

OTHER

Sponsor Role lead

Responsible Party

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Prof. Claude Pichard

Head, Clinical Nutrition

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Claude Pichard, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Geneva

Locations

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Geneva University Hospital

Geneva, , Switzerland

Site Status

Countries

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Switzerland

References

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Pataky Z, Genton L, Spahr L, Lazarevic V, Terraz S, Gaia N, Rubbia-Brandt L, Golay A, Schrenzel J, Pichard C. Impact of Hypocaloric Hyperproteic Diet on Gut Microbiota in Overweight or Obese Patients with Nonalcoholic Fatty Liver Disease: A Pilot Study. Dig Dis Sci. 2016 Sep;61(9):2721-31. doi: 10.1007/s10620-016-4179-1. Epub 2016 May 3.

Reference Type DERIVED
PMID: 27142672 (View on PubMed)

Related Links

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http://www.hug-ge.ch/

Geneva university hospital

Other Identifiers

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10-231

Identifier Type: -

Identifier Source: org_study_id