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Citrulline and Protein Metabolism in the Malnourished Elderly People (CIPROAGE)

Primary Purpose

Metabolism, Elderly

Status
Completed
Phase
Not Applicable
Locations
France
Study Type
Interventional
Intervention
Citrulline
Amino acids
Sponsored by
Assistance Publique - Hôpitaux de Paris
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metabolism focused on measuring citrulline, protein-energy malnutrition, aged, protein biosynthesis, amino acid

Eligibility Criteria

70 Years - undefined (Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • elderly hospitalised in geriatric medicine or in following care and rehabilitation, moderately malnourished
  • aged more than 70 years
  • recent moderate undernutrition (30 g/l < albuminemia < 35 g/l and 18 < BMI < 22 or a score of the Mini Nutritional Assessment (MNA) < 17 with albuminemia > 30 g/l)
  • ingesta of at least 20 kcal / kg / d and 0,8 g / kg / d of proteins

Exclusion Criteria:

  • hospitalisation < 21d
  • C reactive protein (CRP) > 50 mg / l
  • end-stage cardiac insufficiency
  • severe digestive incapacity
  • renal insufficiency (Creatinine Clearance < 30 ml / mn)
  • respiratory failure
  • MMS < 18
  • uncontrolled acute or chronic infectious pathology (HIV, tuberculosis)
  • corticoids treatment
  • evolutionary neoplasia
  • palliative phase of severe pathology
  • Mental Mini Score status of Folstein (MMS) < 8
  • parenteral nutrition
  • active chronic hepatitis or cirrhosis
  • participation in another trial

Sites / Locations

  • Hôpital Emile Roux

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

1

2

Arm Description

Citrulline

Amino acids

Outcomes

Primary Outcome Measures

Whole body protein synthesis rate in the post-absorptive state measured by the isotopic dilution of L-leucine (1-13C expressed in g / kg of lean mass / 24h)

Secondary Outcome Measures

clinical tolerance

Full Information

First Posted
July 11, 2008
Last Updated
December 29, 2013
Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
Kyowa Hakko Kogyo (Japan) providing the amino acids
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1. Study Identification

Unique Protocol Identification Number
NCT00714675
Brief Title
Citrulline and Protein Metabolism in the Malnourished Elderly People
Acronym
CIPROAGE
Official Title
Citrulline Supplementation in Elderly Malnourished and Hospitalised Subjects: Effects on Protein Metabolism
Study Type
Interventional

2. Study Status

Record Verification Date
December 2013
Overall Recruitment Status
Completed
Study Start Date
December 2009 (undefined)
Primary Completion Date
January 2013 (Actual)
Study Completion Date
January 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
Kyowa Hakko Kogyo (Japan) providing the amino acids

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The aim of this study is to evaluate the effects of a supplementation of citrulline for three weeks in elderly malnourished and hospitalised subjects on muscle protein synthesis.
Detailed Description
Malnutrition in the elderly causes an important public health problem because their response to re nutrition is highly decreased. Several experimental studies have shown that an amino acid named citrulline could avoid this, by restoring protein synthesis. The treated group will receive each morning for three weeks a supplementation of 10 g of citrulline and the control group, non essential amino acids in iso-nitrogenous quantity to the 10g of citrulline. During the three weeks of supplementation, clinical tolerance and physical exercise will be evaluated regularly. On the 21st day, whole body protein synthesis rate in the post-absorptive state will be measured by the isotopic dilution of L-leucine (1-13C expressed in g / kg of lean mass / 24h) as well as other parameters of the protein turn-over in the post-absorptive and post-prandial state.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metabolism, Elderly
Keywords
citrulline, protein-energy malnutrition, aged, protein biosynthesis, amino acid

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
27 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Citrulline
Arm Title
2
Arm Type
Active Comparator
Arm Description
Amino acids
Intervention Type
Dietary Supplement
Intervention Name(s)
Citrulline
Intervention Description
1 unit of 10 g L-Citrulline, 1 time on morning during 21 days
Intervention Type
Dietary Supplement
Intervention Name(s)
Amino acids
Intervention Description
1 unit of an equivalent quantity of iso nitrogenous of non-essential amino acids(alanine, aspartate, glycine, serine, histidine, proline), 1 time on morning during 21 days.
Primary Outcome Measure Information:
Title
Whole body protein synthesis rate in the post-absorptive state measured by the isotopic dilution of L-leucine (1-13C expressed in g / kg of lean mass / 24h)
Time Frame
after 3 weeks of treatment
Secondary Outcome Measure Information:
Title
clinical tolerance
Time Frame
Every day

10. Eligibility

Sex
All
Minimum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: elderly hospitalised in geriatric medicine or in following care and rehabilitation, moderately malnourished aged more than 70 years recent moderate undernutrition (30 g/l < albuminemia < 35 g/l and 18 < BMI < 22 or a score of the Mini Nutritional Assessment (MNA) < 17 with albuminemia > 30 g/l) ingesta of at least 20 kcal / kg / d and 0,8 g / kg / d of proteins Exclusion Criteria: hospitalisation < 21d C reactive protein (CRP) > 50 mg / l end-stage cardiac insufficiency severe digestive incapacity renal insufficiency (Creatinine Clearance < 30 ml / mn) respiratory failure MMS < 18 uncontrolled acute or chronic infectious pathology (HIV, tuberculosis) corticoids treatment evolutionary neoplasia palliative phase of severe pathology Mental Mini Score status of Folstein (MMS) < 8 parenteral nutrition active chronic hepatitis or cirrhosis participation in another trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jean-Claude Melchior
Organizational Affiliation
Assistance Publique - Hôpitaux de Paris
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hôpital Emile Roux
City
Limeil-Brevannes
ZIP/Postal Code
94
Country
France

12. IPD Sharing Statement

Citations:
PubMed Identifier
17953788
Citation
Moinard C, Nicolis I, Neveux N, Darquy S, Benazeth S, Cynober L. Dose-ranging effects of citrulline administration on plasma amino acids and hormonal patterns in healthy subjects: the Citrudose pharmacokinetic study. Br J Nutr. 2008 Apr;99(4):855-62. doi: 10.1017/S0007114507841110. Epub 2007 Oct 22.
Results Reference
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PubMed Identifier
16608884
Citation
Osowska S, Duchemann T, Walrand S, Paillard A, Boirie Y, Cynober L, Moinard C. Citrulline modulates muscle protein metabolism in old malnourished rats. Am J Physiol Endocrinol Metab. 2006 Sep;291(3):E582-6. doi: 10.1152/ajpendo.00398.2005. Epub 2006 Apr 11.
Results Reference
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Citrulline and Protein Metabolism in the Malnourished Elderly People

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