- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04554082
Evaluation of Micronutrients in Obese Patients
Impact of Zinc to Copper Ratio and Lipocalin 2 in Obese Patients Undergoing Sleeve Gastrectomy.
The aim of the study primarily was to investigate the value of zinc to copper ratio as possible biomarker of trace elements imbalance in morbidly obese subjects undergoing LSG.
Secondly to correlate zinc to copper ratio with lipocalin 2 (Lcn2) with respect to Anthropometric measurements and other metabolic biomarkers.
Prospective study will be carried out on 120 morbidly obese adult subjects with a body mass index (BMI) score above 40 along with presence of obesity-related comorbidity. Investigations will be measured preoperative and 9 months postoperative after performing Laparoscopic sleeve gastrectomy; for Body mass index (BMI) and waist circumference. As well as for complete blood count and biochemical biomarkers as fasting blood glucose, lipid profile, serum iron and ferritin. Serum Ceruloplasmin, Zn and Cu levels, followed by calculation of zinc to copper ratio. CRP, serum insulin, serum leptin and lipocalin-2 (Lcn2) will be determined.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
CONSORT 2010 Flow Diagram
Materials and methods:
Recruitment Morbidly obese subjects attending clinic at Surgery department for laparoscopic sleeve gastrectomy Alexandria University Hospitals.
Pre-assignment Details adult morbidly obese subjects were included age above 20 years, BMI above 40 Suffering from comorbidities as hypertension, DM, dyslipidemia. Assigned participants were clinically evaluated for comorbidities as hypertension, DM, dyslipidemia.
As well as signs of nutritional deficiency as anemia, brittle nails.
Group Information one group of participants eligible for laparoscopic sleeve gastrectomy were assigned according to their will to participate in study.
Period of evaluation:
First visit: preoperative for clinical assessment of participants, determine BMI and waist circumference and withdrawal of serum blood sample Second visit: within one month after surgery to make sure that no complication occurred after surgery.
Third visit: nine months postoperative for revaluation of participants, determine BMI and waist circumference, and withdrawal of a serum blood sample
Number of participants at initiating the period of study. They were 120 morbidly obese subjects. Number of participants at the end of the period of study. They were 107 subjects, 13 obese subject withdraw from study as they didn't come during follow up period after 9 months.
Participants according Sex (69 females, and 38 male), with the mean age of 41.6±8.9 years. The mean preoperative BMI was 47.43±5.4 kg/m2. Then, they were evaluated 9 months after LSG.
Preoperative and Postoperative Clinical characteristics and metabolic variables in studied subjects.
Preoperative 9 months postoperative P Body weight (Kg) 129.7 ± 12.1 93.4 ±13.6 0.0013* BMI (kg/m2) 47.43±5.4 35.7±3.8 0.0052* Waist circumference (cm) 130.00 ± 4.68 91.82 ± 3.73 0.001* Systolic BP (mmHg) 146.0±17.0 132.0±11.0 0.001* Total cholesterol (mmol/L) 5.85 ± 0.41 4.64 ± 0.31 0.035* Triglycerides (mmol/L) 2.20 ± 0.23 1.92 ± 0.24 0.106 HDL cholesterol (mmol/L) 1.23 ± 0.19 1.39 ± 0.2 0.041* LDL cholesterol (mmol/L) 3.37 ± 0.23 2.97 ± 0.21 0.022* HOMA-IR 2.64 ± 1.3 1.44 ± 0.81 0.013* S. Leptin (ng/ml) 102.87 ± 49.16 33.47 ±12.76 0.0001* CRP (mg/L) 8.4±5.91 3.2±2.98 0.001* Lipocalin 2 (µg/L) 107.24±36.8 51.6±12.73 0.001* Albumin (g/dl) 4.05±0.21 3.91±0.29 0.113
*Statistically significant at (p≤0.05).
Outcome measures:
primarily was to investigate the value of zinc to copper ratio as possible biomarker of TE imbalance in morbidly obese subjects undergoing LSG.
For detection of presence of micronutrient deficiency in morbid obesity in form of zinc to copper ratio and re-evaluate it after loss of weight
Secondly to correlate it with lipocalin 2 (Lcn2) with respect to Anthropometric measurements and other metabolic markers prospectively.
As zinc to copper ratio is considered as biomarker of micronutrient status; therefore, correlate it with other biomarkers of inflammation (lipocalin 2) and other parameters as BMI, FBG to determine if micronutrient status improve after weight loss or not Time frame: 9 months.
Follow-up and outcome parameters:
All studied subjects will be followed up for early postoperative complications (within the first month) as Bleeding or Leak. Then they will be reviewed after 9 months postoperatively for assessment of anthropometric measurements, control of preoperative comorbidities, and manifestations of TE deficiencies (anemia, hair loss, teeth problems, edema. etc.).
Anthropometric parameters
Body mass index (BMI) and waist circumference will be measured preoperative and 9 months postoperative.
Biochemical parameters
Fasting blood samples will be collected from participants prior to surgery and nine months postoperative, after overnight fast and divided into two tubes; EDTA for complete blood count, the rest into plastic tubes and serum sample.
Serum glucose and Total cholesterol, HDL- cholesterol, LDL- cholesterol, and triglyceride, total protein and Albumin. Serum iron (Fe), and ferritin.
Serum insulin, Ceruloplasmin, Zn and Cu levels, CRP and lipocalin-2 (Lcn2) .
Statistical analysis
All data will be analyzed with Statistical Package for the Social Sciences version 20 software (SPSS, Inc., Chicago, IL). Results will be displayed as mean ± SD. Paired Student's t-test used to compare the data pre-operative and nine months postoperative. The chi-squared test used for category variables. Spearman correlation coefficient used to detect the correlation between different variables. Statistical correlations calculated by Pearson's correlation test. P < 0.05 is considered significant.
Study Type
Enrollment (Actual)
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- micronutrient deficiency in morbid obese subjects Adults.
- BMI above 40
- presence of comorbidities as hypertenion, DM, dislipidemia
Exclusion Criteria:
- all causes which might cause micronutrient deficiency as presence of gastroesophageal reflux
- all causes which may cause increase obesity "BMI" as hormonal disturbance ; hypothyroidism or cushing, females receiving contraceptive pills
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Preoperative Clinical characteristics and metabolic biomarkers
BMI and biochemical parameters including trace elements in patients undergoing laparoscopic sleeve gastrectomy before surgery
|
bariatric surgery to loss weight
|
9 months' Postoperative metabolic biomarkers
BMI and biochemical parameters including trace elements in patients 9 months after laparoscopic sleeve gastrectomy
|
bariatric surgery to loss weight
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evaluation of zinc to copper ratio as biomarker of micro-nutrient deficiency
Time Frame: nine months
|
detect if there are micronutrient deficiency in morbid obesity in form of zinc to copper ratio and re-evaluate it after loss of weight
|
nine months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
correlate zinc to copper ratio to lipocalin 2 and other metabolic biomarkers
Time Frame: nine months
|
zinc to copper ratio is considered as biomarker of micronutrient status; therefore, it is correlated it with BMI, other biomarkers of inflammation (lipocalin 2) and other parameters as BMI, FBG to determine if micronutrient status improve after weight loss or not
|
nine months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Hala M Demerdash, MD, Alexandria University Hospitals
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 0304707
- 00018699 (Other Identifier: Ethics committee Alexandria University)
- 00012098 (Other Identifier: IRB)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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