Disease Mechanisms and Markers for Non-alcoholic Steatohepatitis in a Population With Non-alcoholic Fatty Liver Disease: a Prospective Cohort Study With Biobank
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 500
- 试验地点
- 1
- 主要终点
- Development of NASH
研究概览
简要总结
The aim of the present prospective NAFLD cohort study (with biobank), of obese subjects with proven NAFLD based on liver biopsy and/or MRI, is to study factors contributing to the development of NASH in patients with simple steatosis and to identify and validate non-invasive markers for the diagnosis of NASH.
详细描述
Non-alcoholic fatty liver disease (NAFLD) is with 20-30% the most prevalent liver disorder in Western society. Most patients with NAFLD have no or few, mainly aspecific symptoms; and generally there is a silent progression of simple steatosis to NASH and in the end liver-related morbidity and mortality.
Further insight in factors contributing to the initiation of NASH in patients with simple steatosis and early diagnosis are essential for identifying future therapeutic options and to limit the risk of complicated NASH (i.e. fibrosis, and cirrhosis with portal hypertension) HCC, liver-related mortality and extrahepatic morbidity.
This cohort study, with both a cross-sectional and a longitudinal part, will include obese subjects (BMI ≥ 30 kg/m2, age 18-65) with proven NAFLD based on liver biopsy and/or MRI.
All participants will be asked to complete several questionnaires (i.e. demographics, clinical data, SF-36, GAD-7 and PHQ-9, FFQ, SQUASH, and Baecke), and to undergo anthropometric measurements. Furthermore, blood, urine, faeces and exhaled air will be collected and a fibroscan and DEXA-scan will be performed. Additionally, participants will be asked to participate in a multi-sugar test for intestinal permeability.
The majority of eligible subjects will undergo/have undergone a MRI or liver biopsy for clinical reasons. It is to be expected that about 33% of subjects will be asked to undergo a MRI for study purpose only.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •NAFLD diagnosis based on evidence of hepatic steatosis, either by imaging (using MRI) or by histology.
- •BMI ≥ 30 kg/m2
- •Between 18 - 65 years of age
排除标准
- •Incompetent to understand and/or sign the informed consent.
- •Causes for secondary hepatic fat accumulation such as significant alcohol consumption, medications, Wilson's disease, viral infections, starvation or parenteral nutrition, among others, and conditions associated with microvesicular steatosis
- •Ethanol consumption exceeding more than 14 standard beverages per week for males and more than 7 standard beverages per week for female.
- •Not able or willing to undergo MRI (for example claustrophobia, ICD, pacemaker).
- •Not willing to be informed about unexpected findings by MRI
- •Unwilling to collect bio samples.
- •Pregnancy and breastfeeding.
- •Indication or planned for bariatric surgery within one year after inclusion or a history of bariatric surgery.
- •Diagnosis of liver cirrhosis and/or hepatocellular carcinoma.
- •Current diagnosis of extrahepatic malignancy(s) or prior diagnosis within last 5 years.
- •Individuals about to undergo or recovering from a surgical or otherwise medical procedure that will interfere with data collection and analyses planned within the current cohort, will initially be excluded from participation, but are offered the opportunity to participate at a later moment in time
结局指标
主要结局
Development of NASH
时间窗: 10 years
次要结局
- Prevalence of hepatic complications of NAFLD(10 years)
- Prevalence of extrahepatic complications of NAFLD(10 years)
研究者
Ger Koek
MD, PhD
Maastricht University Medical Center