Fatty Acids, Genes and Microbiota in Fatty Liver

Completed

• Conditions: Nonalcoholic Fatty Liver Disease; Steatosis; Nonalcoholic Steatohepatitis

• Registration Number: NCT02148471
• Lead Sponsor: Johane Allard

Brief Summary

The first aim of this study is to assess oxidative stress and nutritional status in patients with elevated liver enzymes who were found to have either simple steatosis (SS) or nonalcoholic steatohepatitis (NASH) or normal histological findings on liver biopsy by measuring liver lipid peroxides and tumor necrosis factor (TNF)-α, liver pathology and immunohistochemistry, liver function tests, liver and red blood cell membrane fatty composition, insulin resistance (IR) parameters, plasma lipid peroxides, plasma antioxidant vitamins and antioxidant power, lipid profile, subject demographics, medical history and medication use. The second aim is to detect differences in hepatic gene expression (messenger RNA, mRNA) and epigenetic regulation (micro RNA, miRNA) between patients with SS or NASH and healthy controls, in addition to determine in patients with non-alcoholic fatty liver disease (NAFLD = SS+NASH combined) whether there is an association between hepatic n-3 PUFA content and gene expression. The third aim is to determine the intestinal microbiome (microbial composition and metagenome) in patients with SS or NASH and healthy controls.

Detailed Description

NASH is associated with obesity, diabetes and hyperlipidemia. Fat accumulation in the liver is likely due to variable degrees of disordered fatty-acid metabolism and insulin resistance (IR). Liver steatosis, especially polyunsaturated fatty acids (PUFA) in the liver, increases lipid peroxidation and is associated with a reduction in the antioxidant defense system. This oxidative stress can lead to increased production of pro-inflammatory cytokines (TNF-α, transforming growth factor-beta) contributing to the development of steatohepatitis and fibrosis.TNF-α - may further contribute to IR. In addition, changes in fatty acid composition within the liver may influence lipid metabolism and inflammation. In particular, n-3 PUFA have an effect on the insulin sensitivity, transcription of antioxidant genes, inflammatory response and production of reactive oxygen species. Differences might be seen on the gene expression level (mRNA) and also in epigenetic regulation (miRNA).

Microbiota composition might influence energy metabolism, and inflammatory tone and IR through increased endotoxemia and therefore could also play a role in the development of NAFLD.

Study Timeline

• Study Start: 2003-10
• Study First Submitted: 2014-05-23
• Study First Submitted QC: 2014-05-23
• Study First Posted: 2014-05-28
• Primary Completion: 2015-08
• Study Completion: 2015-08
• Status Verified: 2016-05
• Last Update Submitted: 2016-05-10
• Last Update Posted: 2016-05-12

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 205

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Hepatic fatty acid composition in total lipids in liver biopsy	Baseline	Gas chromatography
Hepatic gene expression	Baseline	mRNA by microarray
Intestinal microbiota composition	Baseline	Illumina 16S technology

Secondary Outcome Measures

Name	Time	Method
Hepatic liver antioxidant power	Baseline	Test kit
Lipid peroxides in the liver	Baseline	Test kit
Hepatic microRNA expression in the liver	Baseline	NanoString
Short-chain fatty acids in stool	Baseline	Gas chromatography
Intestinal microbiota - specific organisms and groups	Baseline	Quantitative real-time polymerase chain reaction
Intestinal microbiome on a genetic level	Baseline	Illumina sequencing technology
Plasma endotoxin	Baseline	Limulus assay

Trial Locations

Locations (1)

Toronto General Hospital; 🇨🇦 Toronto, Ontario, Canada