The Link Between Obesity And Vitamin D in Bariatric Patients With Omega-loop Bypass Surgery (LOAD)
The Link Between Obesity And Vitamin D in Bariatric Patients With Omega-loop Bypass Surgery: a Randomized Controlled, Double-blinded Clinical Supplementation Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
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Vienna, Austria, 1090
- Medical University of Vienna
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Planned omega loop bypass surgery
- 25-hydroxy vitamin D < 75 nmol/l
- BMI >40 or ≥35 kg/m2 with co-morbidities e.g. diabetes mellitus, hypertension
- Body weight <140 kg (due to limitation of DEXA measurement)
- Capability to consent
Exclusion Criteria:
- Another planned form of bariatric surgery
- Hypercalcemia (calcium >2.63 mmol/l) or hypocalcemia (<1.75 mmol/l)
- Renal insufficiency (creatinine >133 μmol/l or GFR <50 ml/min)
- Primary hyperparathyroidism
- Malignancy
- Infection e.g. human immunodeficiency virus
- Medical conditions requiring daily calcium supplements or antacid use
- Known hypersensitivity to cholecalciferol
- No capability to consent
- Imprisoned persons
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Active Comparator: Intervention
The loading dose of 300 000 IU is divided into three doses (100 000 IU) and will be given over the first months.
All patients in the intervention group will receive the first loading dose of 100 000 IU at day of discharge.
The second (2 weeks) and third (4 weeks postoperative) administration will be given based on the 25-hydroxy vitamin D concentration.
After the last respectively third loading dose a maintenance dose of 3420 IU per day should maintain the high 25-hydroxy vitamin D concentration.
It should be administered for up to 46 weeks (until follow-up visit)
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Placebo Comparator: Placebo
The placebo loading dose (oil) is divided into three administrations and will be given over the first months.
All patients in the placebo group will receive the first placebo loading dose at day of discharge.
After the last placebo loading dose a maintenance dose of 3420 IU per day should maintain the 25-hydroxy vitamin D concentration.
It should be administered for up to 46 weeks (until follow-up).
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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25-hydroxy vitamin D levels
Time Frame: 24 weeks postoperatively
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25-hydroxy vitamin D levels after 24 weeks measured in intervention and placebo group, adjusting for the baseline value as covariate
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24 weeks postoperatively
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Prevalence of sufficient vitamin D
Time Frame: 24 weeks postoperatively
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Number of patients reaching 25-hydroxyvitamin D levels above 75 nmol/l
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24 weeks postoperatively
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Prevalence of vitamin D deficiency
Time Frame: 24 weeks postoperatively
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Prevalence of vitamin D deficiency
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24 weeks postoperatively
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Co-morbidities
Time Frame: 24 weeks postoperatively
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Prevalence of Co-morbidities
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24 weeks postoperatively
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Prescribed medication
Time Frame: 24 weeks postoperatively
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Change in prescribed medication
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24 weeks postoperatively
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Body weight, body composition
Time Frame: 24 weeks postoperatively
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Change in body weight and body composition by bioelectrical impedance analysis
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24 weeks postoperatively
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Blood pressure
Time Frame: 24 weeks postoperatively
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Change of vital signs (blood pressure)
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24 weeks postoperatively
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Laboratory parameters
Time Frame: 24 weeks postoperatively
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Change in laboratory parameters compared to baseline: vitamin D status, bone turnover markers, calcium homeostasis, parathyroid hormone, inflammation, insulin resistance
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24 weeks postoperatively
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Depression symptoms
Time Frame: 24 weeks postoperatively
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Prevalence of depression symptoms assessed by Beck Depression Inventory Questionnaire
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24 weeks postoperatively
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Bone mineral density and body fat content
Time Frame: 24 weeks postoperatively
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Assessment of bone mineral density and total body fat content by DEXA
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24 weeks postoperatively
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Liver condition
Time Frame: 24 weeks postoperatively
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Measurement of liver stiffness and fat content by FibroScan and CAP
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24 weeks postoperatively
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Dietary assessment
Time Frame: 24 weeks postoperatively
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Dietary assessment will be documented with a 5-day food record to calculate vitamin D intake and the Mediterranean Score (questionnaire with calculated score)
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24 weeks postoperatively
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Gut microbiota composition
Time Frame: 24 weeks postoperatively
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Association between vitamin D, gut microbiota and surgery-induced weight loss, by collecting stool samples
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24 weeks postoperatively
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Vitamin D in adipose and liver tissue
Time Frame: during surgery
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For instance, for the purposes of describing adipose depot vitamin D concentrations and expression of enzymes in subcutaneous, visceral adipose and liver tissue samples will be collected during the omega loop gastric bypass surgery.
Furthermore, the liver tissue samples should be used in addition for a histological examination as extended diagnostics (NAFLD/ NASH).
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during surgery
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Bernhard Ludvik, M.D., Division of Endocrinology & Metabolism, Department of Internal Medicine III, Medical University of Vienna
Publications and helpful links
General Publications
- Kruschitz R, Wakolbinger M, Schindler K, Prager G, Hoppichler F, Marculescu R, Ludvik B. Effect of one-anastomosis gastric bypass on cardiovascular risk factors in patients with vitamin D deficiency and morbid obesity: A secondary analysis. Nutr Metab Cardiovasc Dis. 2020 Nov 27;30(12):2379-2388. doi: 10.1016/j.numecd.2020.08.011. Epub 2020 Aug 20.
- Luger M, Kruschitz R, Winzer E, Schindler K, Grabovac I, Kainberger F, Krebs M, Hoppichler F, Langer F, Prager G, Marculescu R, Ludvik B. Changes in Bone Mineral Density Following Weight Loss Induced by One-Anastomosis Gastric Bypass in Patients with Vitamin D Supplementation. Obes Surg. 2018 Nov;28(11):3454-3465. doi: 10.1007/s11695-018-3353-2.
- Luger M, Kruschitz R, Kienbacher C, Traussnigg S, Langer FB, Prager G, Schindler K, Kallay E, Hoppichler F, Trauner M, Krebs M, Marculescu R, Ludvik B. Vitamin D3 Loading Is Superior to Conventional Supplementation After Weight Loss Surgery in Vitamin D-Deficient Morbidly Obese Patients: a Double-Blind Randomized Placebo-Controlled Trial. Obes Surg. 2017 May;27(5):1196-1207. doi: 10.1007/s11695-016-2437-0.
- Luger M, Kruschitz R, Kienbacher C, Traussnigg S, Langer FB, Schindler K, Wurger T, Wrba F, Trauner M, Prager G, Ludvik B. Prevalence of Liver Fibrosis and its Association with Non-invasive Fibrosis and Metabolic Markers in Morbidly Obese Patients with Vitamin D Deficiency. Obes Surg. 2016 Oct;26(10):2425-32. doi: 10.1007/s11695-016-2123-2.
- Luger M, Kruschitz R, Marculescu R, Haslacher H, Hoppichler F, Kallay E, Kienbacher C, Klammer C, Kral M, Langer F, Luger E, Prager G, Trauner M, Traussnigg S, Wurger T, Schindler K, Ludvik B. The link between obesity and vitamin D in bariatric patients with omega-loop gastric bypass surgery - a vitamin D supplementation trial to compare the efficacy of postoperative cholecalciferol loading (LOAD): study protocol for a randomized controlled trial. Trials. 2015 Aug 5;16:328. doi: 10.1186/s13063-015-0877-9.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- LOAD
- 2013-003546-16 (EudraCT Number)
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