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Influence of the Diversity and Composition of the Microbiota in the Development of Pediatric Fatty Liver

Not Applicable
Conditions
Obesity
Metabolic Syndrome
Non-Alcoholic Fatty Liver Disease
Interventions
Other: Multidisciplinary intervention program
Registration Number
NCT04575506
Lead Sponsor
Universidad Pública de Navarra
Brief Summary

The objectives of the present study are: 1) to identify the intestinal and salivary microbiota associated with the presence and severity of hepatic steatosis in children (Study I: case-control study), and 2) to develop a personalized 12-week intervention program based on diet and exercise to examine its effects on the diversity and composition of the microbiota in children with hepatic steatosis (Study II: intervention study)

Detailed Description

The MicroKid project will acts first as a case-control study (Study I) in order to identify the hepatic steatosis and intestinal and salivary microbiota in children grouped as non-overweight, obese-non-hepatic steatosis, and obese-hepatic steatosis. Then, an intervention study (Study II) will be developed for those children with obesity (i.e., obese-non-hepatic steatosis, and obese-hepatic steatosis groups).

Methodology: A total of 60 children, 8-12 years-old, will be assigned to control (non-overweight children, N= 20), obese-non-hepatic steatosis (children with obesity, but without hepatic steatosis, N=20), and obese-hepatic steatosis (children with obesity and hepatic steatosis, N= 20) groups (Study I: case-control study). The obesity and obesity + hepatic steatosis groups will attend to a 12-weeks healthy lifestyle education program (2 days/month) and home-based exercise program (minimum 3 days/week) (Study II: intervention study).

The combined intervention program for the Study II will include: i) healthy lifestyle education program focused on dietary and lifestyle guidelines for both children and parents (2 days/month, 60 min), and ii) exercise program based on high-intensity interval training which combines aerobic and resistance training (at least 3 days/week, from 38 to 44 min).

Measurements: In the Study I (i.e., case-control study), all participants will be evaluated at baseline. For the Study II (i.e., intervention study), only those participants that belongs to obese-non-hepatic steatosis and obese-hepatic steatosis groups, will be additionally evaluated after the intervention program (12-week). The following outcomes will be measured: hepatic fat fraction and abdominal adiposity (magnetic resonance imaging), intestinal and salivary microbiota, body composition (bioimpedance), cardiometabolic risk factors, liver enzymes, physical fitness (field-fitness tests), physical activity (accelerometry), sleep (accelerometry), dietary habits (24h recalls, and food frequency questionnaires), and pubertal development and sociodemographic characteristics will be measured.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Obesity defined based on the sex-and-age specific body mass index standards
  • 8-12 years old
Exclusion Criteria
  • Medical conditions that hamper their participation in the exercise program

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Obesity-Non-hepatic steatosisMultidisciplinary intervention programHealthy lifestyle education program focused on dietary and lifestyle guidelines for both children and parents (2 days/month, 60 min), and exercise program based on high-intensity interval training which combine aerobic and resistance training (at least 3 days/week, from 38 to 44 min).
Obesity-Hepatic steatosisMultidisciplinary intervention programHealthy lifestyle education program focused on dietary and lifestyle guidelines for both children and parents (2 days/month, 60 min), and exercise program based on high-intensity interval training which combine aerobic and resistance training (at least 3 days/week, from 38 to 44 min).
Primary Outcome Measures
NameTimeMethod
Hepatic fatbaseline and post-test (12-weeks)

Hepatic fat fraction measured by magnetic resonance imaging before and after 12-weeks intervention program

Intestinal microbiotabaseline and post-test (12-weeks)

Diversity and composition of intestinal microbiota before and after 12-weeks intervention program

Salivary microbiotabaseline and post-test (12-weeks)

Diversity and composition of salivary microbiota before and after 12-weeks intervention program

Secondary Outcome Measures
NameTimeMethod
Visceral adipositybaseline and post-test (12-weeks)

Visceral adipose tissue measured by magnetic resonance imaging before and after 12-weeks intervention program

Fat massbaseline and post-test (12-weeks)

Fat mass measured by bioimpedance before and after 12-weeks intervention program

Fat-free massbaseline and post-test (12-weeks)

Fat free mass measured by bioimpedance before and after 12-weeks intervention program

Glucosebaseline and post-test (12-weeks)

Glucose measured by blood analysis before and after 12-weeks intervention program

Insulinbaseline and post-test (12-weeks)

Serum insulin concentration measured by ELISA before and after 12-weeks intervention program

Cholesterolbaseline and post-test (12-weeks)

Serum cholesterol measured by spectrophotometry before and after 12-weeks intervention program

Triglyceridesbaseline and post-test (12-weeks)

Serum triglycerides measured by spectrophotometry before and after 12-weeks intervention program

Leptinbaseline and post-test (12-weeks)

Plasma leptin concentration measured by ELISA before and after 12-weeks intervention program

Adiponectinbaseline and post-test (12-weeks)

Plasma adiponectin measured by ELISA before and after 12-weeks intervention program

C-reactive proteinbaseline and post-test (12-weeks)

Plasma hs-CRP measured by ELISA before and after 12-weeks intervention program

Waist circumferencebaseline and post-test (12-weeks)

Waist circumference measured by non-elastic tape before and after 12-weeks intervention program

Systolic and diastolic blood pressurebaseline and post-test (12-weeks)

Systolic and diastolic blood pressure measured by sphygmomanometer before and after 12-weeks intervention program

Physical fitnessbaseline and post-test (12-weeks)

Cardiorespiratory fitness, upper- and lower-limbs, and speed agility measured by the Alpha-fitness battery.

Physical activity and sleepbaseline and post-test (12-weeks)

Physical activity and sleep measured by accelerometry before and after 12-weeks intervention program

24h dietary habitsbaseline and post-test (12-weeks)

24h dietary habits assessed by 24h recalls before and after 12-weeks intervention program

Dietary habits historybaseline and post-test (12-weeks)

Dietary habits history assessed by food frequency questionnaires before and after 12-weeks intervention program

Subcutaneous abdominal adipositybaseline and post-test (12-weeks)

Subcutaneous abdominal adipose tissue measured by magnetic resonance imaging before and after 12-weeks intervention program

Intermuscular abdominal adipositybaseline and post-test (12-weeks)

Intermuscular abdominal adipose tissue measured by magnetic resonance imaging before and after 12-weeks intervention program

Weightbaseline and post-test (12-weeks)

Weight measured by bioimpedance before and after 12-weeks intervention program

Heightbaseline and post-test (12-weeks)

Height measured by stadiometer before and after 12-weeks intervention program

Trial Locations

Locations (2)

Complejo Hospitalario de Navarra

🇪🇸

Pamplona, Spain

Public University of Navarra

🇪🇸

Pamplona, Spain

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