Fiber Supplementation and Metformin Combination Therapy in Adolescents With Severe Obesity and Insulin Resistance: Interactions With the Gut Microbiome.
试验速览
- 阶段
- 3 期
- 状态
- 招募中
- 入组人数
- 90
- 试验地点
- 1
- 主要终点
- Changes in HOMA-IR
研究概览
简要总结
This is a 12-month, single center, three-arm parallel design, double-blind, randomized clinical trial, to compare the effects of supplemental dietary fiber and metformin (MET) alone and in combination over 12 months on glucose metabolism (insulin resistance [IR]), inflammation and BMI in adolescents with obesity and IR, and to assess the relationship between therapeutic intervention(s) and changes in gut microbiome composition and function.
Since MET and FIBER have been shown to reduce weight and increase insulin sensitivity through distinct but overlapping mechanisms of action, our central hypothesis is that the combination of FIBER + MET will have a synergistic effect and be more effective than FIBER or MET alone in improving metabolic function (IR) and reducing BMI and inflammation in adolescents with obesity, IR and family history (FM) of T2DM.
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研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Investigator)
盲法说明
Participants and research team will be blinded to the type of intervention allocated to each arm until the end of the study. Concealment will be protected by secure, password protected website. The group not on MET (fiber alone) will receive a placebo pill. The group not on fiber will also receive a placebo, composed of the same base solution without added fibers.
入排标准
- 年龄范围
- 12 Years 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 12-18 years
- •BMI percentile > 95% for age/sex;
- •Total weight fluctuation over past 6 months < 10%;
- •HOMA-IR > 3.16;
- •FH of T2DM (first or second-degree relative).
排除标准
- •Current use of insulin or diagnosis of T2DM;
- •Systolic or diastolic blood pressure (BP) > 99th percentile for age and sex;
- •Acute infectious or inflammatory condition over the preceding 1 month; hospitalization > 48 hrs;
- •History of chronic disease such as inflammatory bowel disease, chronic severe liver or kidney disease or neurologic disorders;
- •Active malignancy;
- •Concomitant use of medication/investigational drug known to affect body weight in the past year;
- •Antibiotic use in past 60 days; probiotic and/or prebiotic supplements use in the past 30 days; use of lipid-lowering and anti-inflammatory medication.
研究组 & 干预措施
MET
MET (850 mg po bid - standard of care) + Fiber placebo daily
干预措施: Metformin 850 mg oral tablet bid (Drug)
FIBER
Fiber supplementation [35g fiber daily] + MET placebo po bid
干预措施: Supplemental fiber mixture (35 g total) composed of 6g of Oligofructose + 12g of resistant maltodextrin + 12g of acacia gum + 5g of PGX. (Dietary Supplement)
FIBER + MET
Fiber supplementation [35g fiber daily] + MET 850 mg po bid
干预措施: Metformin 850 mg oral tablet bid (Drug)
FIBER + MET
Fiber supplementation [35g fiber daily] + MET 850 mg po bid
干预措施: Supplemental fiber mixture (35 g total) composed of 6g of Oligofructose + 12g of resistant maltodextrin + 12g of acacia gum + 5g of PGX. (Dietary Supplement)
结局指标
主要结局
Changes in HOMA-IR
时间窗: Baseline, 6, and 12 months
Change in HOMA-IR value
次要结局
- Changes in perceived hunger and satiety(Baseline, 6, and 12 months)
- Changes in gut microbiota composition(Baseline, 6, and 12 months)
- Changes in gut microbiome functions(Baseline, 6, and 12 months)
- Changes in body weight(Baseline, 6, and 12 months)
- Changes in body mass index (BMI)(Baseline, 6, and 12 months)
- Changes in body composition(Baseline, 6, and 12 months)
- Changes in inflammation(Baseline, 6, and 12 months)
- Changes in metabolic function(Baseline, 6, and 12 months)
- Changes in satiety hormones(Baseline, 6, and 12 months)
- Changes in quality of life(Baseline, 6, and 12 months)
- Changes in intestinal barrier integrity(Baseline, 6, and 12 months)