Effect of L-Citrulline Supplementation on NAFLD in Adolescents With Obesity

January 18, 2022 updated by: Ma Eugenia Garay Sevilla, Universidad de Guanajuato

Effect of Oral L-Citrulline Supplementation on Liver Function and Non-Alcoholic Fatty Liver Disease in Adolescents With Obesity

One of the comorbidities of obesity is nonalcoholic fatty liver disease (NAFLD). L-citrulline is a non-protein amino acid that has shown positive effects on the degree of fat retention and metabolic profile in NAFLD. The objective is to assess the effect of oral L-citrulline supplementation on liver function and nonalcoholic fatty liver in adolescents with obesity. A clinical study will be carried out in 40 adolescents (15-19 years) with obesity, they will be divided into a control group that will receive a placebo and an experimental group that will receive 6 g of l-citrulline per day for eight weeks.

Study Overview

Detailed Description

It is hypothesized that l-citrulline supplementation decreases liver enzymes and the degree of hepatic steatosis in adolescents with obesity. The aim of the study is to assess the effect of oral L-citrulline supplementation on liver function and nonalcoholic fatty liver in adolescents with obesity. A prospective randomized, double-blind clinical study will be carried out in 40 adolescents (15-19 years) with obesity, they will be divided into a control group that will receive a placebo (carboxymethyl cellulose) and an experimental group that will receive 6 g of pure l-citrulline per day per eight weeks. At the beginning and end of the intervention, anthropometric, biochemical and metabolic data will be evaluated, as well as tests of function and degree of hepatic steatosis.

Study Type

Interventional

Enrollment (Actual)

42

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Guanajuato
      • León, Guanajuato, Mexico, 37000
        • University of Guanajuato

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

15 years to 19 years (Child, Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Adolescents between 15 and 19 years old, residents of the city of León, Guanajuato, with obesity due to BMI ≥30 kg / m2 equivalent to the categorization of adults. That they are in stage 5 of Tanner scale with diagnosis of mild, moderate or severe NAFLD and / or alterations in liver enzyme levels. Not be under nutritional treatment, not be smokers, not taking multivitamins, if so, a wash time of 30 days will be given. Not be allergic to l-citrulline or watermelon. Alcohol consumption less than 21 standard drink units for men and 14 standard drink units for women per week (Standard drink: any drink with more than 14 g of pure alcohol).

Exclusion Criteria:

  • Present intolerance to l-citrulline or allergy to watermelon.
  • Have an adherence of less than 80 percent of the treatments.
  • Present other causes of liver disease.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Citrulline group
Group of adolescents supplemented orally with 6 g / day of pure L-citrulline in capsules. The dose will be met by taking four (3 g) capsules in the morning before the first meal and four capsules (3 g) in the evening after the last meal.
The intervention will consist of oral supplementation of six grams of pure l-citrulline for eight weeks.
Placebo Comparator: Placebo group
Group of adolescents supplemented with placebo (carboxymethyl cellulose). The indication for taking will be the same as in the experimental group, four capsules in the morning before the first meal and four capsules at night, after the last meal.
The intervention will consist of oral carboxymethyl cellulose supplementation as a placebo.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Degree of hepatic steatosis
Time Frame: Baseline to 8 weeks

The degree of hepatic steatosis will be evaluated by abdominal ultrasound. It will be diagnosed as:

  1. Mild, when an increase in echogenicity and hepatomegaly are observed.
  2. Moderate, when sound attenuation is added.
  3. Severe, when the wall of the portal vessels and the diaphragm are not visible.
Baseline to 8 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Glucose
Time Frame: Baseline to 8 weeks
Glucose will be evaluated by the GOD-PAD Lakeside glucose oxidase method.
Baseline to 8 weeks
Insulin
Time Frame: Baseline to 8 weeks
The insulin level will be measured by ELISA (ALPCO) method. The HOMA-IR index will be calculated to determine insulin resistance.
Baseline to 8 weeks
Insulin resistance
Time Frame: Baseline to 8 weeks
The HOMA-IR index to determine insulin resistance will be calculated from serum glucose and insulin levels.
Baseline to 8 weeks
Lipid profile
Time Frame: Baseline to 8 weeks
The lipid profile will be measured by the modified Huang method of the Spinreact brand.
Baseline to 8 weeks
LDL-cholesterol
Time Frame: Baseline to 8 weeks
LDL-cholesterol will be determined using the Friedwald formula.
Baseline to 8 weeks
Urea levels
Time Frame: Baseline to 8 weeks
Urea levels will be obtained by the Urease GLDH kinetic method.
Baseline to 8 weeks
Uric acid levels
Time Frame: Baseline to 8 weeks
Uric acid will be evaluated by peroxidase enzymes and colorimetry.
Baseline to 8 weeks
Liver function
Time Frame: Baseline to 8 weeks
Liver function will be evaluated using the liver enzymes alanine aminotransferase and aspartate aminotransferase by the UV enzymatic kinetic method, as well as with alkaline phosphatase by the optimized kinetic method and direct bilirubin by the DMSO method (dimethyl sulfoxide-Malloy-Evelyn reaction).
Baseline to 8 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Ma. E Garay-Sevilla, PhD, Universidad de Guanajuato
  • Study Chair: Verónica I Tovar-Villegass, Bachelor, Universidad de Guanajuato

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 5, 2021

Primary Completion (Actual)

December 19, 2021

Study Completion (Actual)

January 15, 2022

Study Registration Dates

First Submitted

April 25, 2021

First Submitted That Met QC Criteria

April 29, 2021

First Posted (Actual)

May 4, 2021

Study Record Updates

Last Update Posted (Actual)

January 19, 2022

Last Update Submitted That Met QC Criteria

January 18, 2022

Last Verified

January 1, 2022

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

At the request of the researcher.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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