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Идёт набор NCT06329349

Metabolic Flexibility to Predict Lifestyle Interventions Outcomes

Без фазы С лечением Obesity

Ориентир для пациента и семьи

Простыми словами

Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.

Что изучают
В протоколе указаны: Exercise, Combined Exercise + Diet.
Кому может быть актуально
Состояния в реестре: Obesity. Базовые параметры: 25 лет — 45 лет · Женщины.
Что важно проверить
Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
Где проводится
Чехия
Следующий шаг
Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
Официальное название

Whole Body and Gut Microbiome Metabolic Flexibility to Predict Lifestyle Intervention Outcomes

Обзор

Weight loss is a cornerstone of diabetes (T2D) management, yet in clinical practice, its delivery is limited by its perceived burdensome nature and variability in response. Personalization of the interventions to increase their success rate is an unmet clinical need. The proposed project MEPHISTO (Whole body and gut microbiome metabolic flexibility to predict lifestyle intervention outcomes) would aim to identify predictive features related to successful weight loss upon sequential exercise and diet intervention in people living with obesity. To this end, the study aims to conduct a clinical trial where the investigators would implement state-of-the-art physiological phenotyping of metabolic flexibility at the whole-body level and at the level of the gut in persons with obesity before and after exercise and diet + exercise intervention to identify predictive signatures of successful weight loss

Подробное описание

Among the influential determinants impacting the efficacy and health outcomes of an intervention is an individual's level of metabolic flexibility (MetFlex). MetFlex denotes the body's capacity to adapt in response to alterations in metabolic demands and nutrient availability. Impaired MetFlex is evident in conditions such as obesity and diabetes, yet it may be ameliorated through lifestyle interventions such as exercise training or caloric restriction similar to improvements in insulin sensitivity. However, MetFlex has not been studied as a potential mechanism associated with successful weight loss. The decline in MetFlex, i.e. the limited cellular/tissue ability to manage excess or deficiency in energy substrates leads to compromised mitochondrial function and excessive lipid accumulation in ectopic tissues, resulting in metabolic disorders such as T2D or metabolic syndrome.

Another potential player predicting an individual's capacity to respond to lifestyle interventions is the gut microbiota (gut microbiome and metabolome, MIME). It was repeatedly shown to be among the most important sources of inter-individual variability when it comes to the development of obesity and responsiveness to dietary intervention The microbiome does not only influence host physiology directly, e.g. through contact with immune cells, but also through the vast array of metabolites produced, i.e. the microbiota-derived metabolome. The composition of the gut microbiota and the microbiota-derived metabolome is largely shaped by the host's diet, as this represents the main source of substances and energy for the microbiota. It is therefore striking that published studies to date have yielded rather inconsistent results regarding dietary interventions to alter gut microbiota composition. The discrepancy can be explained by the large variability of individual microbiomes at the beginning of the intervention, and similarly the baseline MIME signature significantly determines weight loss success.

Here the investigators present a complex project to investigate whether whole body and gut MetFlex can be further explored and used as ex-ante predictors of successful weight loss following exercise and dietary interventions, thus providing proof of concept and paving the way to personalized lifestyle interventions.

Вмешательства

  • Другое Exercise
    12 weeks, 3 times a week of progressive endurance aerobic exercise (150 to 400kcal AEE per session)
  • Другое Combined Exercise + Diet
    12 weeks, 25% caloric reduction, based on PMID: 37069434

Первичные конечные точки

  • Change in metabolic flexibility (MetFlex (ΔRQ 200-0)) [Срок оценки: 18 months]
  • Change in insulin sensitivity [Срок оценки: 18 months]
Вторичные конечные точки (3)
  • Glucose tolerance relate to primary outcomes changes [Срок оценки: 18 months]
  • HbA1c relate to primary outcomes changes [Срок оценки: 18 months]
  • Insulin sensitivity relate to primary outcomes changes [Срок оценки: 18 months]

Критерии участия

Критерии включения

  • BMI>30
  • age 25-45 years

Критерии исключения

  • active cancer
  • diabetes (medical history, fasting glycemia >7.6 and/or 2hOGTT glycemia >11.1)
  • uncontrolled endocrine diseases
  • corticosteroid therapy
  • immune-suppressive therapy
  • pregnancy
  • breastfeeding

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Распределение
Рандомизированное
Модель
Параллельные группы
Маскирование
Открытое
Основная цель
Лечение

Центры проведения

Чехия · 3 центра
  • University Hospital Kralovske Vinohrady — Prague
  • Third Medical Faculty,Charles University — Prague
  • Faculty of Sports Science — Prague

Публикации

  • Ludlova M, Koudelkova K, Pallova J, Koudelkova B, Siklova M, Cahova M, Vetrovsky T, Steffl M, Gojda J. Metabolic Flexibility to Predict Lifestyle Interventions Outcomes (MEPHISTO): Protocol for Predictive Validation Study and Randomized Controlled Trial. JMIR Res Protoc. 2025 May 8;14:e67570. doi: 10.2196/67570. PMID 40340957

Идентификаторы

NCT: NCT06329349 · EK VP57/0/2023

Первоисточники (государственные реестры)

Открыть это исследование на ClinicalTrials.gov ↗