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Protein and Magnesium in Ulcerative Colitis

Not Applicable
Conditions
Nutritional Deficiency
Colitis, Ulcerative
Magnesium Deficiency
Protein Deficiency
Inflammatory Bowel Diseases
Interventions
Dietary Supplement: Magnesium acetate mixture (30 mmol/ml)
Dietary Supplement: High-protein diet (2 g/kg/day)
Registration Number
NCT05271838
Lead Sponsor
University of Aarhus
Brief Summary

The aim of the study is to improve the quality of nutritional therapy for patients admitted with Acute Severe Ulcerative Colitis (ASUC) treated with high-dose steroids. This study consists of two randomized interventions and one observational part regarding protein, magnesium, and metabolic stress. First an interventional part aims to explore the effect of a high-protein diet during and after admission on different parameters regarding protein turnover.Second the study aims to explore the degree of magnesium depletion in ASUC. In case of magnesium depletion, the study aims to investigate whether oral magnesium supplementation can regain body stores of magnesium. Last the study aims to observe the degree of metabolic stress, including, the degree of insulin resistance, in ASUC during admission and under treatment with high-dose steroids compared to three weeks after discharge.

Detailed Description

Patients with Acute Severe Ulcerative Colitis (ASUC) may have an altered protein turnover due to inflammation, reduced dietary intake and/or accelerated protein loss. Despite this the level of dietary protein needed to maintain nitrogen balance has never been described in patients with ASUC. Clinical symptoms of ASUC include frequent and bloody diarrhea which alone or simultaneous with a risk of reduced dietary intake and weightloss can lead to magnesium depletion. Magnesium depletion can cause severe symptoms including cardiac arrhythmia and neuromuscular dysfunction which might worsen the disease further. The prevalence of magnesium depletion in ASUC has never been described and furthermore it is not known whether oral supplementation are able to reverse the condition in patients with ASUC.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
36
Inclusion Criteria
  • Age 18 years or older
  • Cognizant
  • Must speak or read Danish or participate in relevant communication in interpreting or translating the study material.
  • Diagnosed with Acute Severe Ulcerative Colitis (ASUC) (documented in the patient journal)
  • Admitted at "Lever-, Mave-, og Tarmsygdomme/ LMT" at Aarhus University Hospital and in medical treatment with high-dose intravenous steroid (Solumedrol 40 mg x 2 daily)
Exclusion Criteria
  • Pregnant and/or lactating women
  • Plasma creatinine > 200 µmol/L (protein intervention only)
  • Patients receiving tube- or parenteral feeding (protein intervention only)
  • Receiving any kind of magnesium supplementation 6 months prior to inclusion (magnesium intervention only)
  • Diagnosed with Type 1 or Type 2 Diabetes Mellitus (observational part only)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
MagnesiumMagnesium acetate mixture (30 mmol/ml)Magnesium oral supplementation
High protein dietHigh-protein diet (2 g/kg/day)High protein diet (2/g/kg/day)
Primary Outcome Measures
NameTimeMethod
24 hour urine carbamide (mmol/d)5 days

Change in 24 hour urine carbamide (mmol/d) from baseline (day 0) to first follow-up (day 5)

Secondary Outcome Measures
NameTimeMethod
plasma carbamide (mmol/l)0, follow-up 1 (day 5) and week 4

Change in plasma carbamide (mmol/l) measured at baseline, follow up 1(day 5) and at week 4.

24 hour urine carbamide (mmol/d)4 weeks

Change in 24 hour urine carbamide (mmol/d) between baseline (day 0) and at week 4

24 hour urine magnesium (mmol/d)3 weeks

Change in 24 hour urine magnesium (mmol/d) between follow up 1 (day 5) and after three weeks.

Fat free mass (FFM) (kg)4 weeks

Change in FFM (kg) between baseline and after four weeks. Measured after minimum 6 hours of fasting by Bioimpedance spectroscopy.

Fasting blood glucose (mmol/l)4 weeks

Change in fasting blood glucose (mmol/l) after a minimum of 6 hours fasting between baseline and week 4

Quality of life (QOL) questionaire (Hjortswang index)3 weeks

Change in QOL-score patient administered QOL-scoring system - Hjortswang index between follow-up 1 (day 5) and after three weeks.

plasma insulin (pmol/l)4 weeks

Change in plasma insulin (pmol/l) between baseline and week 4

Magnesium retention %3 weeks

Change in magnesium retention (%) between follow up 1 (day 5) until after three weeks.

Resting Energy Expenditure (REE)4 weeks

Change in REE between baseline and after four weeks. Measured after minimum 6 hours of fasting by indirect calorimetry.

plasma magnesium (mmol/l)4 weeks

Change in plasma magnesium (mmol/l) between follow-up 1 (day 5) and at week 4

plasma c-peptide (pmol/l)4 weeks

Change in plasma c-peptide (pmol/l) between baseline and week 4

Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)-score4 weeks

Change in HOMA-IR-score between baseline and week 4

24 hour urine creatinine (mmol/d)0, follow up 1 (day 5) and week 4

Change in 24 hour urine creatinine (mmol/d)

Quality of life (QOL) questionaire (SIBDQ)3 weeks

Change in QOL-score patient administered QOL-scoring system - The short bowel inflammatory bowel disease questionaire (SIBDQ) between follow-up 1 (day 5) and after three weeks.

Body weight (kg)4 weeks

Change in body between baseline and after four weeks. Measured after minimum 6 hours of fasting by Bioimpedance spectroscopy.

plasma albumin (g/L)4 weeks

Change in plasma albumin (mmol/l) between follow-up 1 (day 5) and at week 4

Creatinine-clearance (mL/min)0, follow-up 1 (day 5) and week 4

Change in creatinine-clearance (ml/min)

Trial Locations

Locations (1)

Aarhus University Hospital

🇩🇰

Aarhus N, Denmark

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