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The Impact of Hafnia Alvei on Weight Loss and Glycaemic Control After Bariatric Surgery

Not Applicable
Active, not recruiting
Conditions
Obesity
Type 2 Diabetes
Interventions
Dietary Supplement: Hafnia alvei HA4597™
Other: Placebo
Registration Number
NCT05170867
Lead Sponsor
Universidade Nova de Lisboa
Brief Summary

This study aims to investigate the effects of Hafnia alvei HA4597 TM supplementation on weight loss and glycemic control after bariatric surgery. Patients undergoing Roux-en-Y gastric bypass will receive probiotics or placebo, twice a day, for 90 days, one month after surgery. Outcomes will be measured at baseline, and 3, 6, 9 and 12 months after the surgery.

Detailed Description

Gut microbiota dysbiosis is associated with the pathophysiology of obesity. Bariatric surgery is an effective treatment for obesity that induces changes in the gut microbiota. However, recent studies indicate that the gut microbiota is not fully restored after bariatric surgery which may limit the potential of the surgery to achieve metabolic control and maintain weight loss. Thus, modulating the gut microbiota with probiotics after bariatric surgery could be an effective strategy to improve the success of the surgery.

This study aims to investigate the effects of Hafnia alvei HA4597 TM supplementation on weight loss and glycemic control after bariatric surgery. Patients undergoing Roux-en-Y gastric bypass will receive probiotics or placebo, twice a day, for 90 days, one month after surgery. Outcomes will be measured at baseline, and 3, 6, 9 and 12 months after the surgery.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
49
Inclusion Criteria
  • Men and women between 18 and 65 years
  • BMI ≥35 kg/m2 and at least one severe obesity-related complications, or BMI ≥40 kg/m2
  • Undergoing Roux-en-Y gastric bypass
  • Willing to take a probiotic/placebo supplement twice a day for 60 days
  • Willing and able to provide written informed
Exclusion Criteria
  • Intake of antibiotics and/or probiotics in the previous 12 weeks
  • Weight change >5% in the previous 12 weeks
  • Diagnosis of gastrointestinal disease or other significant illness
  • Pregnancy or breastfeeding

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Probiotic groupHafnia alvei HA4597™Two capsules of Hafnia alvei HA4597™ probiotic/day (5 x 107 CFU/day) for 90 days
Placebo groupPlaceboTwo identical capsules of placebo/day for 90 days
Primary Outcome Measures
NameTimeMethod
HbA1cAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in HbA1c levels (%) from baseline.

Excess weight lossAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in percentage of excess weight loss from baseline.

Secondary Outcome Measures
NameTimeMethod
C-peptideAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in c-peptide levels (ng/mL) levels from baseline.

Proportion of subjects losing more than 50% of baseline excess weightAt visit 1 (Baseline), visit 5 (12 months after bariatric surgery).

Percentage of subjects losing \>50% of baseline excess weight from baseline to visit 5 (12 months after bariatric surgery).

Caseinolytic protease BAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in caseinolytic protease B (pM) from baseline.

InsulinAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in insulin levels (μU/mL) levels from baseline.

LDL cholesterolAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in low-density lipoprotein (LDL) cholesterol (mg/dL) levels from baseline.

TriacylglyceridesAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in triacylglycerides (mg/dL) levels from baseline.

Gut microbiotaAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in gut microbiota from baseline. Bacterial DNA will be extracted from faecal samples. 16S rRNA gene will be sequenced by next-generation sequencing (NGS). All the identified bacterial phyla, genus and species will be expressed in percentage.

Gastrointestinal quality of lifeAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in gastrointestinal quality of life by the Gastrointestinal Quality of Life Index (GIQLI) questionnaire from baseline. The GIQLI is a 36 -item questionnaire and consists of 5 different subscales. The total score is calculated as the sum of the 36 items each ranged from 0 to 4. The final score range from 0 to 144 points (lower scores indicate more unfavorable conditions).

Gut microbiota metabolitesAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in short-chain fatty acids (acetate, propionate and butyrate) concentrations (mg/mL) from baseline. Short-chain fatty acids will be measured by targeted metabolomics.

Total cholesterolAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in total cholesterol levels (mg/dL) from baseline.

Free fat massAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in free fat mass (kg) from baseline.

Fasting blood glucoseAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in fasting blood glucose levels (mg/dL) levels from baseline.

HDL cholesterolAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in high-density lipoprotein (HDL) cholesterol (mg/dL) levels from baseline.

Body fat massAt visit 1 (Baseline), visit 2 (3 months after bariatric surgery), visit 3 (6 months after bariatric surgery), visit 4 (9 months after bariatric surgery), visit 5 (12 months after bariatric surgery).

Changes in percentage of body fat mass from baseline.

Trial Locations

Locations (1)

NOVA Medical School|Faculdade de Ciências Médicas, Universidade NOVA de Lisboa

🇵🇹

Lisboa, Portugal

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