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Diet Impact on Hepatic Transcriptomics and Lipidomics in Pre-diabetes (DGENE-NAFLD)

Primary Purpose

Pre-diabetes

Status
Recruiting
Phase
Not Applicable
Locations
Canada
Study Type
Interventional
Intervention
Low fat diet
High fat diet
Sponsored by
Laval University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Pre-diabetes

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Males and females 18 to 60 years of age. Non-smoker Waist circumference > 102 cm for men and > 88 cm for women. Plasma triglyceride levels > 1,7 mmol/L at the screening visit. Fasting plasma glucose levels > 6,1 mmol/L at the screening visit. Fasting plasma insulin levels above the upper limit of normal at the screening visit. Subjects must be willing to give written informed consent and able to adhere to the diet schedule and visit schedule. Patients should be otherwise healthy, without abnormal renal function or coagulation. Exclusion Criteria: Patients with extreme dyslipidemias, such as familial hypercholesterolemia will be excluded. Subjects will be excluded if they have cardiovascular disease (CHD, cerebrovascular disease or peripheral arterial disease) or if they are taking other medications known to affect lipoprotein metabolism (eg. steroids, beta blockers, thiazide diuretics, other lipid lowering agents, significant alcohol intake etc.). Subjects who are in a situation or have any condition that, in the opinion of the investigator, may interfere with optimal participation in the study. Individuals with a history of mental instability, drug or alcohol abuse within the past 2 years or individuals who have been treated or are being treated for severe psychiatric illness that, in the opinion of the investigator, may interfere with optimal participation in the study. Disorders of the hematologic, digestive, or central nervous systems, including cerebrovascular disease and degenerative disease, that would limit study evaluation or participation. Known impairment of renal function (creatinine >2.0 mg/dL), dysproteinemia, nephrotic syndrome, or other renal disease. Subjects with coagulopathy (prothrombin time [PT] or partial thromboplastin time [PTT] at Visit 1 higher than 1.5 times control). Patients who are known to have tested positive for human immunodeficiency virus (HIV). Patients who have used any investigational drug within 30 days of the first clinic visit. Diabetic patients are excluded from the study. Uncontrolled endocrine or metabolic disease known to influence serum lipids or lipoproteins. Clinically euthyroid subjects on replacement doses of thyroid hormone are eligible for enrollment.

Sites / Locations

  • Institute of Nutrition and Functional Foods (INAF)Recruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Low fat diet

High fat diet

Arm Description

During 3 days, subjects eat a diet low in fat (percent of total caloric intake: 15.0% from proteins; 65.0% from carbohydrates; 20.0% from fat: 4.0% from saturated fat; 10.0% from monounsaturated fat; 6.0% from polyunsaturated fat

During 3 days, subjects eat a diet high in fat (percent of total caloric intake: 15.0% from proteins; 45.0% from carbohydrates; 40.0% from fat: 8.0% from saturated fat; 22.0% from monounsaturated fat; 10.0% from polyunsaturated fat

Outcomes

Primary Outcome Measures

Change in the expression of key genes in lipid metabolism including LDL-receptor, acetyl-CoA acetyltransferase 2, apolipoprotein B, proproprotein convertase subtilisin/kexin type 9, microsomal triglyceride transfer protein
Change in the expression of key genes in liver inflammation including C-reactive protein, Interleukin-6, Interleukin-15, cell adhesion molecules, E-selectin
Change in the expression of key genes in hepatic fibrogenesis including transforming growth factor beta 1, a-smooth muscle actin, type-1 collagen, connective tissue growth factor

Secondary Outcome Measures

Change in liver's key lipid pathways (lipidomics) including lysophosphatidylcholine, phosphatidylcholine, diglyceride.
Identify bacteria strains involved in the control of blood glucose such as C elegans.

Full Information

First Posted
June 12, 2023
Last Updated
July 20, 2023
Sponsor
Laval University
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1. Study Identification

Unique Protocol Identification Number
NCT05965973
Brief Title
Diet Impact on Hepatic Transcriptomics and Lipidomics in Pre-diabetes
Acronym
DGENE-NAFLD
Official Title
Short-term Impact of a Low Carbohydrate/High Unsaturated Fat Diet on Hepatic Transcriptomics and Lipidomics in Individuals With Pre-diabetes - A Pilot Study
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 9, 2023 (Actual)
Primary Completion Date
March 31, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Laval University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases, affecting 25% to 30% of the global population and nearly one third of the population in North America. NAFLD is defined as an excessive accumulation of lipids within hepatocytes in the absence of significant alcohol consumption or other causes of chronic liver disease. These patients usually present with hepatic steatosis observed on imaging studies and elevated liver enzymes with clinical features of insulin resistance (IR), including pre-diabetes, type 2 diabetes mellitus (T2DM), arterial hypertension, dyslipidemia, and visceral obesity. The minimum criterion for a histologic diagnosis of NAFLD is >5 percent steatotic hepatocytes in a liver tissue section. The exact mechanism for the development of NAFLD is unclear, although the current evidence indicates that it is likely a complex interplay among neurohormones, intestinal dysbiosis, nutrition, and genetics. IR plays a crucial role in NAFLD pathophysiology mainly by increasing adipocyte lipolysis, resulting in the circulation of more free fatty acids available for hepatic uptake and increasing hepatic de novo lipogenesis. There is yet no approved pharmacologic option for the treatment of NAFLD. Current international guidelines on NAFLD emphasize the importance of lifestyle modifications for all patients with NAFLD and recommend 7-10% of weight loss and a "healthy diet", without suggesting any particular diet. Recent data provide some support for the beneficial role of low carbohydrate (CHO)/high unsaturated fatty acid (both monounsaturated (MUFAs) and polyunsaturated (PUFAs)) dietary patterns for decreasing hepatic steatosis. This proposal addresses this important research gap by leading to advances regarding the impact of a short-term low CHO/high PUFAs/MUFAs dietary intervention on improving hepatic gene expression profiles and lipid composition in individuals with pre-diabetes. The proposed study is unique because all meals and foods will be provided to participants under carefully controlled isocaloric conditions to maintain a constant bodyweight with optimal energy and macronutrient intake control. The primary objective of the proposed research is to investigate how replacement of dietary CHOs by unsaturated fatty acids (both PUFAs and MUFAs) affects liver fat composition and liver transcriptomics in subjects with pre-diabetes.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pre-diabetes

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
Participant
Masking Description
Triple (Participant, Investigator, Outcomes Assessor)
Allocation
Randomized
Enrollment
6 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Low fat diet
Arm Type
Experimental
Arm Description
During 3 days, subjects eat a diet low in fat (percent of total caloric intake: 15.0% from proteins; 65.0% from carbohydrates; 20.0% from fat: 4.0% from saturated fat; 10.0% from monounsaturated fat; 6.0% from polyunsaturated fat
Arm Title
High fat diet
Arm Type
Experimental
Arm Description
During 3 days, subjects eat a diet high in fat (percent of total caloric intake: 15.0% from proteins; 45.0% from carbohydrates; 40.0% from fat: 8.0% from saturated fat; 22.0% from monounsaturated fat; 10.0% from polyunsaturated fat
Intervention Type
Other
Intervention Name(s)
Low fat diet
Intervention Description
During 3 days, subjects eat a diet low in fat (percent of total caloric intake: 15.0% from proteins; 65.0% from carbohydrates; 20.0% from fat: 4.0% from saturated fat; 10.0% from monounsaturated fat; 6.0% from polyunsaturated fat
Intervention Type
Other
Intervention Name(s)
High fat diet
Intervention Description
During 3 days, subjects eat a diet high in fat (percent of total caloric intake: 15.0% from proteins; 45.0% from carbohydrates; 40.0% from fat: 8.0% from saturated fat; 22.0% from monounsaturated fat; 10.0% from polyunsaturated fat
Primary Outcome Measure Information:
Title
Change in the expression of key genes in lipid metabolism including LDL-receptor, acetyl-CoA acetyltransferase 2, apolipoprotein B, proproprotein convertase subtilisin/kexin type 9, microsomal triglyceride transfer protein
Time Frame
At Day 3 and day 20 (at the end of the two 3-day diets)
Title
Change in the expression of key genes in liver inflammation including C-reactive protein, Interleukin-6, Interleukin-15, cell adhesion molecules, E-selectin
Time Frame
At Day 3 and day 20 (at the end of the two 3-day diets)
Title
Change in the expression of key genes in hepatic fibrogenesis including transforming growth factor beta 1, a-smooth muscle actin, type-1 collagen, connective tissue growth factor
Time Frame
At Day 3 and day 20 (at the end of the two 3-day diets)
Secondary Outcome Measure Information:
Title
Change in liver's key lipid pathways (lipidomics) including lysophosphatidylcholine, phosphatidylcholine, diglyceride.
Time Frame
At Day 3 and day 20 (at the end of the two 3-day diets)
Title
Identify bacteria strains involved in the control of blood glucose such as C elegans.
Time Frame
At Day 3 and day 20 (at the end of the two 3-day diets)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females 18 to 60 years of age. Non-smoker Waist circumference > 102 cm for men and > 88 cm for women. Plasma triglyceride levels > 1,7 mmol/L at the screening visit. Fasting plasma glucose levels > 6,1 mmol/L at the screening visit. Fasting plasma insulin levels above the upper limit of normal at the screening visit. Subjects must be willing to give written informed consent and able to adhere to the diet schedule and visit schedule. Patients should be otherwise healthy, without abnormal renal function or coagulation. Exclusion Criteria: Patients with extreme dyslipidemias, such as familial hypercholesterolemia will be excluded. Subjects will be excluded if they have cardiovascular disease (CHD, cerebrovascular disease or peripheral arterial disease) or if they are taking other medications known to affect lipoprotein metabolism (eg. steroids, beta blockers, thiazide diuretics, other lipid lowering agents, significant alcohol intake etc.). Subjects who are in a situation or have any condition that, in the opinion of the investigator, may interfere with optimal participation in the study. Individuals with a history of mental instability, drug or alcohol abuse within the past 2 years or individuals who have been treated or are being treated for severe psychiatric illness that, in the opinion of the investigator, may interfere with optimal participation in the study. Disorders of the hematologic, digestive, or central nervous systems, including cerebrovascular disease and degenerative disease, that would limit study evaluation or participation. Known impairment of renal function (creatinine >2.0 mg/dL), dysproteinemia, nephrotic syndrome, or other renal disease. Subjects with coagulopathy (prothrombin time [PT] or partial thromboplastin time [PTT] at Visit 1 higher than 1.5 times control). Patients who are known to have tested positive for human immunodeficiency virus (HIV). Patients who have used any investigational drug within 30 days of the first clinic visit. Diabetic patients are excluded from the study. Uncontrolled endocrine or metabolic disease known to influence serum lipids or lipoproteins. Clinically euthyroid subjects on replacement doses of thyroid hormone are eligible for enrollment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Patrick Couture, MD, PhD
Phone
418-654-2106
Email
patrick.couture@fmed.ulaval.ca
First Name & Middle Initial & Last Name or Official Title & Degree
André Tremblay, PhD
Phone
418-656-2131
Ext
411417
Email
andre.tremblay@fsaa.ulaval.ca
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patrick Couture, MD, PhD
Organizational Affiliation
Laval University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Institute of Nutrition and Functional Foods (INAF)
City
Québec
State/Province
Quebec
ZIP/Postal Code
G1V 0A6
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Patrick Couture, MD, PhD
Phone
418-654-2106
Email
patrick.couture@fmed.ulaval.ca
First Name & Middle Initial & Last Name & Degree
André Tremblay, PhD
Phone
418-656-2131
Ext
411417
Email
andre.tremblay@fsaa.ulaval.ca
First Name & Middle Initial & Last Name & Degree
Patrick Couture, MD, PhD

12. IPD Sharing Statement

Learn more about this trial

Diet Impact on Hepatic Transcriptomics and Lipidomics in Pre-diabetes

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