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Effect of Dietary Macronutrient Composition

Not Applicable
Completed
Conditions
Metabolic Syndrome
Obesity
Non-alcoholic Fatty Liver Disease
Interventions
Other: Low-fat diet
Other: Low-carbohydrate diet
Registration Number
NCT01371396
Lead Sponsor
University of Texas Southwestern Medical Center
Brief Summary

The purpose of this study is to understand why Hispanics who are overweight have a higher incidence of fatty liver disease.

Detailed Description

Obesity is a major factor driving the increased prevalence of hepatic steatosis in the US. However, little is known regarding the relationship between dietary intake and hepatic fat deposition or about the factors that promote loss of hepatic steatosis. Here, the investigators will determine how differences in dietary composition affect the development and regression of fatty liver. The investigators hypothesize that Hispanic subjects with metabolic syndrome will have higher liver fat synthesis rates compared to African American subjects.

Using detailed in vivo, serial measurements of fuel metabolism (GC/MS and NMR) fatty acid metabolism will be measured in the liver and periphery. This will be the first study in which these two methodologies are used together to assess both glucose and fatty acid metabolism in the same subjects. Subjects will be tested before and after a dietary weight-loss intervention producing 6% body weight loss over 5 months.

The specific aims are as follows:

AIM 1: Determine the contribution of peripheral and dietary fat to liver-TG in Hispanics and African Americans with metabolic syndrome.

Hypothesis: De novo lipogenesis will contribute to liver-TG in greater quantities compared to African Americans.

AIM 2: Determine the effects of low-CHO and low-fat diets on liver fat regression.

Hypothesis: Compared to a low-fat diet, a low-CHO diet will markedly decrease markers of inflammation coincident with greater improvements in insulin sensitivity as assessed by an intravenous glucose tolerance test.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
24
Inclusion Criteria
  • Elevated serum ALT or metabolic syndrome
  • African American or Hispanic
  • Nondiabetic
  • Men or women
  • Smokers and nonsmokers
  • Pre- and post-menopausal (+/- HRT)
  • Stable body weight
  • Age 20-65 years
  • BMI between 25-45 kg/m2
Exclusion Criteria
  • Diabetes or Pregnancy
  • Ethanol intake: males > 140 g/week, females > 70 g/week
  • Chronic hepatitis B or chronic hepatitis C
  • Hemochromatosis or Wilson's Disease
  • Autoimmune hepatitis or primary biliary cirrhosis

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
Hispanic subjectsLow-carbohydrate dietSubjects will identify as Hispanic ethnicity.
African American subjectsLow-fat dietSubjects will self-identify as African American in origin.
African American subjectsLow-carbohydrate dietSubjects will self-identify as African American in origin.
Hispanic subjectsLow-fat dietSubjects will identify as Hispanic ethnicity.
Primary Outcome Measures
NameTimeMethod
de novo lipogenesisChange from Baseline in fatty acid synthesis at 5 months

In vivo measurement is made of liver fatty acid synthesis using stable isotope administration and analysis of plasma samples by GS/MS

Secondary Outcome Measures
NameTimeMethod
Adipose fatty acid fluxChange from Baseline in adipose fat flux at 5 months

A stable isotope is infused and the rate of adipose fatty acid release is calculated after analyzing blood samples.

Dietary fatty acid clearance to liverChange from Baseline in dietary fat clearance at 5 months

Using a dietary stable isotope we will quantitate fat absorption and recycling of fat through the liver.

Trial Locations

Locations (1)

Center for Human Nutrition

🇺🇸

Dallas, Texas, United States

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