Effect of High Protein Diet on Hepatic Steatosis in Patients With MAFLD

NCT ID: NCT06749704

Last Updated: 2024-12-27

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-27

Study Completion Date

2027-05-01

Brief Summary

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MAFLD is a growing problem in India. Its pathophysiology is complex, but focused on abnormal substrate handling due to mitochondrial dysfunction reflecting as metabolic inflexibility. Nutrition is the cornerstone of management. The ideal macronutrient distribution within a hypocaloric diet is not known yet. Evidence from experimental and a few human studies in obese, highlight the role of dietary proteins, independent of calorie restriction, in reducing hepatic steatosis by improving the cellular and systemic bioenergetics.

Detailed Description

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Novelty: First study to assess the effect of high protein diet (HPD) in comparison to a standard protein diet (SPD) within a calorie restricted diet, on both the cellular and systemic bioenergetics in patients with MAFLD.

Objectives: Aims to see the effect of HPD on hepatic steatosis, cellular and systemic bioenergetics, along with metabolic parameters in patients with MAFLD.

Method: In this RCT, patients with MAFLD (n=140) with or without MS, would be randomized into HPD or SPD groups (i.e. 70 in each group), and parameters like hepatic steatosis (CAP by Transient elastography (FibroScan), cellular bioenergetics by oxygen consumption rate (OCR) and extracellular acidification rate (ECAR) as measured using Seahorse Analyzer, and Indirect Calorimetry will be used to assess the fasting and postglucose challenge (Oral glucose tolerance test) REE and RQ. DEXA scan would be used to assess body composition apart from routine blood tests to assess features of Metabolic syndrome. The serum levels of GLP1, CKK, Ghrelin, FGF21, Adipokines like leptin and adiponectin, NADH/NAD ratio, insulin and glucagon would be measured.

Outcome: A HPD is expected to improve hepatic steatosis, blunted fuel switching (RQ) and cellular bioenergetics (OCR) along with metabolic parameters in patients with MAFLD.

Conditions

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Metabolic Dysfunction Associated Fatty Liver Disease

Keywords

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mitochondrial dysfunction metabolic inflexibility FGF21 resistance

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Open Label
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

As it is a nutritional intervention study masking either the participant or the investigator is not possible

Study Groups

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Standard Treatment Group

The intervention is planned as a supervised dietary supplementation, with a goal of restricting the calorie intake to 20 Kcal/Kg BW/day, with a protein intake of 0.9 gm/Kg BW/day i.e., around 15 % of total calories from protein, 25% from fats and 60% from carbohydrates.

Physical activity recommendations: Brisk walking on a treadmill (at a speed 5-6 Kmph for 60 minutes) OR 5000 steps per day by pedometer counting.

Group Type ACTIVE_COMPARATOR

Normal Protein diet

Intervention Type DIETARY_SUPPLEMENT

Normal protein diet

High Protein Diet

The intervention is planned as a supervised dietary supplementation, with a goal of restricting the calorie intake to 20 Kcal/Kg BW/day, with a protein intake of 1.3 gm/Kg BW/day i.e., around 25 % of total calories from protein, 25% from fats and 50% from carbohydrates. Major portion of the protein would be met by dairy, legumes and pulses along with egg whites.

Physical activity recommendations: Brisk walking on a treadmill (at a speed 5-6 Kmph for 60 minutes) OR 5000 steps per day by pedometer counting.

Group Type EXPERIMENTAL

High protein diet

Intervention Type DIETARY_SUPPLEMENT

High protein diet

Interventions

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High protein diet

High protein diet

Intervention Type DIETARY_SUPPLEMENT

Normal Protein diet

Normal protein diet

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Newly diagnosed treatment naïve consenting adults with MAFLD (controlled attenuation parameter; CAP \>250, BMI\>23 and/or DM) Age 18-65 years

Exclusion Criteria

* • Lean (BMI \<23) patients

* Age \<18 and \>65 years
* Individuals who had been hospitalized with complications of Diabetes mellitus, Chronic Kidney disease, Hypertension in the previous 6 months
* Patients with viral hepatitis
* Patients with significant alcohol consumption (regular consumption of \> 10g per day for females and \> 20g/d in males),
* Patients having chronic inflammatory bowel disease or any chronic and autoimmune diseases will be excluded
* Pregnant \& lactating women
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institute of Liver and Biliary Sciences, India

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jaya Benjamin, PhD

Role: STUDY_DIRECTOR

Institute of Liver and Biliary Sciences

Locations

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Institute of Liver and Biliary Sciences

Delhi, New Delhi, India

Site Status

Countries

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India

Central Contacts

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Kanika Jain, MSc

Role: CONTACT

Phone: 08076030183

Email: [email protected]

Facility Contacts

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Jaya Benjamin, Dr

Role: primary

Kanika Jain, MSc

Role: backup

Other Identifiers

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ILBS-MAFLD-01

Identifier Type: -

Identifier Source: org_study_id