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Intensive Lifestyle Intervention for Remission of Metabolic Syndrome

Not Applicable
Completed
Conditions
Metabolic Syndrome
Registration Number
NCT04116905
Lead Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University
Brief Summary

This is a randomized, prospective clinical trial investigating metabolic syndrome in overweight or obese Chinese individuals. The study aims to evaluate the efficacy of a structured intensive lifestyle intervention program in achieving significant weight reduction (targeting 15% weight loss) and promoting metabolic syndrome remission. Additionally, the research will explore the potential mechanisms underlying these therapeutic effects.

Detailed Description

Background:

Metabolic syndrome is a global public health concern, with prevalence rates ranging from 10% to 84% across different populations. It is strongly associated with multiple chronic non-communicable diseases, including type 2 diabetes, cardiovascular diseases, non-alcoholic fatty liver disease, polycystic ovary syndrome, and certain cancers. Notably, obesity plays a central role in the development of metabolic syndrome, and substantial evidence supports the benefits of significant weight loss in improving its components. Currently, there is a lack of research on lifestyle interventions aimed at weight loss to alleviate metabolic syndrome in affected populations.

Study Design:

This study is a single-center, prospective, randomized controlled trial. Metabolic syndrome (MetS) subjects aged 18-60 years were enrolled and randomly assigned to either an intensive lifestyle intervention group (a low-carbohydrate diet combined with physical exercise, target weight loss of 15%) or a conventional lifestyle intervention group ( energy-restricted diet combined with physical exercise, target weight loss of 7%). Participants underwent a 5-month weight-loss intervention (with monthly follow-ups) followed by a 7-month weight-maintenance phase (with follow-ups every 2 months). During the follow-up period, anthropometric and laboratory parameters were regularly monitored.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
68
Inclusion Criteria
  • BMI of 27-45 kg/m2
  • Metabolic syndrome: meet at least 3 of the following 5 criteria: waist circumference ≥85 cm (male) or 80 cm (female); TG ≥1.7 mmol/L or with lipid-lowering treatment; HDL<1.04 mmol/L(male) /1.3 mmol/L (female);SBP ≥ 130 mmHg and / or DBP ≥ 85 mmHg and / or with diagnosed hypertension and anti-hypertensive treatment; fasting glucose ≥ 5.6 mmol/L and / or with diagnosed type 2 diabetes and hypoglycemic treatment. (If with type 2 diabetes, the process of the disease should not exceed 6 years, with the level of C-P ≥3/4 of the lower limit of limit; if with hypertension, BP ≤ 180/110 mmHg without anti-hypertensive agent, or BP ≤160/100 mmHg with 1-2 kinds of anti-hypertensive agents, or BP ≤140/90 mmHg with 3-4 kinds of anti-hypertensive agents; if with hyper-triglyceridemia, TG ≤ 11.2 mmol/L without lipid-lowering agent, or TG ≤ 5.6 mmol/L with lipid-lowering agent.)
  • Han Chinese
  • Willingness to participate
Exclusion Criteria
  • Participants with metabolic syndrome caused by other secondary factors (genetic diseases related to obesity and hyperlipidemia, Cushing's syndrome, drug-induced obesity and etc.);
  • Participants whose body weight fluctuated by more than 5 kg in the last 6 months; who trying to lose weight in the last 3 months; who had used anti-obesity drugs, oral contraceptive, or glucocorticoids in the last 3 months;
  • Participants with Type 1 diabetes or gestational diabetes or other types of diabetes;
  • Participants with BP ≥ 180/110 mmHg, or malignant hypertension;
  • Participants with previous severe gastrointestinal diseases;
  • Participants with significant dysfunction of heart, liver, kidney and systemic organs (NYHA Class III or IV; ALT and / or AST ≥ 4 times the normal upper limit; GFR < 60 ml/min) or with malignant tumor;
  • Participants with drug abuse or alcohol addiction; with serious mental and neurological disorders;
  • Pregnant or lactating women; those who have planned to give birth within the past 1 year;
  • Participants with special dietary requirements, or with soy products, milk and other daily food allergies;
  • Participants in other clinical trials.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
The remission rate of metabolic syndrome12 months

Participants are considered to have achieved metabolic syndrome remission when they meet ≤2 of the following 5 diagnostic criteria:

1. Waist circumference ≥85 cm (men) / ≥80 cm (women);

2. Fasting triglycerides ≥1.7 mmol/L or current lipid-lowering therapy;

3. HDL cholesterol \<1.04 mmol/L (men) / \<1.30 mmol/L (women);

4. Systolic BP ≥130 mmHg and/or diastolic BP ≥85 mmHg, or diagnosed hypertension with antihypertensive treatment;

5. Fasting glucose ≥5.6 mmol/L, or diagnosed type 2 diabetes with glucose-lowering treatment.

Remission is defined as sustained resolution of ≥3 criteria.

The proportion of participants achieving 15% weight loss from baseline12 months

The proportion of participants achieving 15% weight loss from baseline

Secondary Outcome Measures
NameTimeMethod
Remission of hypertension12 months

The proportion of participants achieving target blood pressure control (either \<130/85 mmHg or \<140/90 mmHg) without antihypertensive medication.

Remission of hyperglycemia12 months

The proportion of participants achieving fasting plasma glucose \<5.6 mmol/L without glucose-lowering medication.

Remission of low HDL-C12 months

The sex-specific proportion achieving therapeutic HDL-C targets (≥1.04 mmol/L in males; ≥1.30 mmol/L in females) without lipid-modifying therapy.

Remission of central obesity12 months

Proportion meeting gender-stratified waist circumference criteria (males \<85 cm; females \<80 cm).

Remission of hypertriglyceridemia12 months

The proportion of participants achieving triglyceride levels \<1.7 mmol/L without lipid-lowering therapy.

Trial Locations

Locations (1)

The Second Affiliated Hospital of Zhejiang University School of Medicine

🇨🇳

Hangzhou, Zhejiang, China

The Second Affiliated Hospital of Zhejiang University School of Medicine
🇨🇳Hangzhou, Zhejiang, China

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