Comparing the Efficacy of Dietary Strategies in Managing Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): a Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Turin, Italy
- Enrollment
- 173
- Locations
- 1
- Primary Endpoint
- Within- and between-group changes in hepatic steatosis [percentage, %]
Overview
Brief Summary
This is a non-blinded, three-arm, parallel, 6-month randomized, longitudinal, and controlled intervention trial. designed to compare the effects of three dietary regimes (Mediterranean diet, low-carbohydrate diet and standard nutritional recommendations) on non-invasive parameters of fat accumulation and liver damage, including radiological and biochemical tests, in overweight or obese subjects with MASLD. Participants were enrollment and screening from the Liver Unit of the Department of Medical Sciences, University of Torino and randomly assigned to one of three groups: a low-carbohydrate diet, a mediterranean diet, or standard nutritional recommendations.
All participants were submitted to the following assessments both at enrollment and at after 6 month at the end of the study: 3-day food record; the Medi-Lite score; anthropometric measurements (weight, height, BMI, waist and neck circumferences); fat mass, fat-free mass by bioelectrical impedance; hand-grip strength; energy expenditure by indirect calorimetry; blood pressure measurement; blood sampling for metabolic variables and biomarkers of liver damage and liver disease measures (Cap, Stiffness and Fib-4).
Detailed Description
This is a three-arm, parallel-group, open-label randomized controlled trial designed to evaluate the effectiveness of three different nutritional interventions on non-invasive markers of liver damage, including radiological and biochemical assessments. Patients with MASLD were recruited from the Liver Unit of the Department of Medical Sciences, University of Torino.
At baseline, participants were randomly assigned to one of the following three groups:
A) Low-carb Diet (LCHO: 35-40% carbohydrates, 30% protein, 30-35% fats.) B) Mediterranean Diet (MeD: 50-60% carbohydrates, 15% protein, 25-35% fats ) C) Control group: standard nutritional recommendations The following evaluations were performed both at baseline and after 6 months at the and of the study: 3-day food record; the Medi-Lite score; anthropometric measurements (weight, height, BMI, waist and neck circumferences, fat mass, fat-free mass by bioelectrical impedance); hand-grip strength; energy expenditure by indirect calorimetry; blood pressure measurement; blood sampling for metabolic variables and biomarkers of liver damage and liver disease measures (Cap, Stiffness and Fib-4).
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 75 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •age ≥18 and \<75 years
- •BMI ≥25 and \<35 kg/m2
- •not having previously received nutritional advice for the liver disease
Exclusion Criteria
- •other causes of liver disease (including viral, autoimmune, cholestatic, genetic, alcoholic, and drug-induced)
- •other diseases or conditions requiring specific dietary recommendations
- •a history of alcohol abuse
- •diabetes mellitus
- •pharmacological treatments potentially interfering with study outcomes (corticosteroids, glucagon-like-peptide 1 agonists, biologic drugs)
- •pregnancy or breastfeeding
- •inability to give written informed consent
- •life expectancy expected to be \<1 year.
Outcomes
Primary Outcomes
Within- and between-group changes in hepatic steatosis [percentage, %]
Time Frame: 6 months
The unit of measure is the percentage (%) of liver fat content, as assessed by transient elastography - FibroScan®.
Within- and between-group changes in Controlled Attenuation Parameter. (CAP) [dB/m]
Time Frame: 6 months
The unit of measure is decibels per meter (dB/m), as measured by transient elastography - FibroScan®.
Secondary Outcomes
- Change in liver stiffness measured by transient elastography - FibroScan®. [kilopascals, kPa](6 months)
- Changes in fat mass percentage(6 months)
- Changes in fibrosis-4 index(6 months)
- Changes in serum transaminase levels(6 months)
- Changes in energy expenditure.(6 months)
- Changes in insulin restistance [mmol/LxμU/mL](6 months)
- Changes in thrombospondin-2 (TSP2) [ng/ml](6 months)
- Changes in C-terminal procollagen 4 (PRO-C4) [ng/ml](6 months)
Investigators
Simona Bo
Associate Professor, MD
University of Turin, Italy