Evaluation the Effect of AKK Formula on Intestinal Microbiota Regulation and Body Composition

The AKK formula, a prebiotic blend, can effectively promote the proliferation of A. muciniphila. In this study, we attempt to explore the clinical efficacy of AKK formula for A. muciniphila proliferation and weight management.

Study Overview

• Status: Completed
• Conditions: Metabolic Syndrome; Body Weight Changes
• Intervention / Treatment: Dietary supplement: Placebo sachet; Dietary supplement: AKK formula prebiotic sachet

Detailed Description

This is a double-blind, randomized, parallel and placebo-controlled study. Subjects are informed to consume the samples daily for 8 weeks. The person who is evaluated as obesity by the investigator will be invited to participate in this trial. In this study, we attempt to explore the clinical efficacy of AKK formula for A. muciniphila proliferation and weight management.

• Study Type: Interventional
• Enrollment (Actual): 70
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Taiwan
  • Taipei, Taiwan, 110
    • Taipei Medical University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Subjects shall have a body mass index (BMI) of >23.0 to <32.5.0 kg/m2.
• Subjects shall have waist circumference of >80 cm for men and women.
• Subject is willing to maintain habitual dietary, lifestyle, and physical activity throughout the trial and do not plan to change the place of living during the study.
• Subject understands the study procedures and signs forms providing informed consent to participate in the study and authorizes the release of relevant protected health information to the Study Investigator.

Exclusion Criteria:

• Clinically important gastrointestinal condition that would potentially interfere with the evaluation of study products (e.g., inflammatory bowel disease, irritable bowel syndrome, gastric reflux, indigestion, dyspepsia, Crohn's disease, celiac disease, history of gastrointestinal surgical intervention for inducing weight loss, gastroparesis, and clinically significant lactose or gluten intolerance or other food/food component allergies).
• Recent (within 2 weeks of Visit 1, Day -7 - screening visit) history of an episode of acute GI illness such as nausea/vomiting or diarrhea (defined as >3 loose or liquid stools/d).
• Self-reported history (within 6 weeks of Visit 1, Day -7 -screening visit) of constipation (< 3 bowel movements/week) or diarrhea (loose stools >3 loose or liquid stools in one day) that in the judgement of the Study Investigator is not due to acute infection (e.g., stomach flu), food poisoning, temporary medication, etc.
• Subjests with mental disorder(depression, schizophrenia), cardiovascular disease/Arrhythmia/Heart Failure/Myocardial Infarction/or other Heart Condition, Hypothyroidism Or Uncontrolled Diabetic Gastrointestinal Disease (Crohn's Disease)/Gastrointestinal Resection Surgery/Irritable Bowel Syndrome, kidney condition, autoimmune disorder, Thyroid or hormonal abnormalities/Abnormalities If the immune system that can affect the weight of thyroid levels, like anemia/porphyrinosis, pancreatitis etc .
• Uncontrolled hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg) as defined by blood pressure measured on Visit 1. Stable use of hypertension medication is allowed (defined as no change in medication regimen within the 3 mo prior to Visit 1.)
• Any known food allergy, intolerance, or sensitivity to study product ingredients.
• Extreme dietary habits, eating disorders or physical activity patterns at the discretion of the Study Investigator.
• History or presence of cancer in the prior 2 years, except for non-melanoma skin cancer.
• Major trauma or any other surgical event within 3 months of Visit 1.
• Signs or symptoms of an active infection of clinical relevance within 5 days of Visit 1.
• Weight loss or gain >4.5 kg in the 3 months prior to Visit 1.
• Current use or planned use/participation in any weight loss regimen during the study period.
• Anti-biotic, antifungal, or antiparasitic use within 3 months of Visit 1 and throughout the study period.
• Use of anti-obesity, blood sugar lowering medications, insulin injections, hormones, diuretics , hormoneal treatment orsteroids within 1 month of Visit 1 and throughout the study period. Use of nasal and non-prescription topical treatments is permitted.
• Chronic use (i.e., daily or on a regular basis) of anti-inflammatory medications (e.g., NSAIDS) within 1 month of Visit 1.
• Use of medications (over-the-counter or prescription) and/or dietary supplements known to influence GI function including, but not limited to prebiotics, probiotics laxatives and/or enemas - including suppositories, fiber supplements, H2 blockers, proton pump inhibitors, antacids, anti-diarrheal agents, antidepressants, and/or anti-spasmodics within 3 weeks of Visit 1. Standard multi-vitamin/multi-mineral supplements are permitted.
• Subject has undergone endoscopy or endoscopy preparation within 3 months prior to Visit 1.
• Exposure to any non-registered drug product, including street drugs, within 4 weeks prior to Visit 1.
• Recent history (within 12 months of Visit 1) of alcohol or substance abuse. Alcohol abuse is defined as >14 drinks/week (1 drink = 12 oz (354 ml) beer, 5 oz (148 ml), or 1 ½ oz (44 ml) distilled spirits).
• Subject has a condition that, in the opinion of the Study Investigator, would interfere with his/her ability to provide informed consent, comply with the study protocol, confound interpretation of study results, or place the subject at undue risk.
• Female subjects who typically experience changes in GI symptoms or bowel habits (e.g., increased or decreased laxation, bloating, abdominal cramping) at the time of menstruation.
• Female subjects with irregular menstruation which does not allow for easy scheduling of stool collection outside of the menstrual period.
• Female subject who is pregnant, planning to be pregnant during the study period, lactating, or is of childbearing potential and is unwilling to commit to the use of a medically approved form of contraception throughout the study period. Subjects who become pregnant during the study will be dismissed from the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Placebo sachet; consume 1 sachet per day for 8 weeks	Dietary supplement: Placebo sachet; 5 g/sachet, containing Indigestible Maltodextrin, Crystalline Maltitol, Calcium Carbonate, Citric Acid, Steviol Glycosides, and flavor. Subjects will consume 1 sachet per day for 8 weeks.
Experimental: AKK formula sachet; consume 1 sachet per day for 8 weeks	Dietary supplement: AKK formula prebiotic sachet; 5 g/sachet, containing AKK formula, Indigestible Maltodextrin, Crystalline Maltitol, Calcium Carbonate, Citric Acid, Steviol Glycosides, and flavor. Subjects will consume 1 sachet per day for 8 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Relative abundance of Akkermansia muciniphila in gut	Collect subject's feces for bacterial analysis. Akkermansia muciniphila will be quantified by quantitative PCR.	Change from Baseline relative abundance of A. muciniphila at 8 weeks
The change of waist circumference	The waist circumference will be assessed by measuring tape. Unit: centimeter	Change from Baseline waist circumference at 4 weeks, and 8 weeks
The change of Waist-to-height ratio	Waist-to-height ratio can be obtained by dividing waist size by height and is an effective indicator of risks associated with obesity.	Change from Baseline Waist-to-height at 4 weeks, and 8 weeks
The change of body mass index (BMI)	BMI is a measurement of a person's leanness or corpulence based on their height and weight, and is intended to quantify tissue mass.The body mass index (BMI, kg/m^2) and body mass (kg) will be assessed by InBody.	Change from Baseline BMI at 4 weeks, and 8 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The change of total body mass	The total body mass (kg) will be assessed by Bioelectrical impedance analysis (BIA).	Change from Baseline total body mass at 4 weeks, and 8 weeks
The change of total lean mass	The total lean mass (kg) will be assessed by Bioelectrical impedance analysis (BIA).	Change from Baseline total lean mass at 4 weeks, and 8 weeks
The change of total fat mass	The total fat mass (kg) will be assessed by Bioelectrical impedance analysis (BIA).	Change from Baseline total fat mass at 4 weeks, and 8 weeks
The change of total fat rate	The total fat rate (%) will be assessed by Bioelectrical impedance analysis (BIA).	Change from Baseline total fat rate at 4 weeks, and 8 weeks
The change of visceral fat volume	The visceral fat volume (cm^2) will be assessed by Bioelectrical impedance analysis (BIA).	Change from Baseline visceral fat volume at 4 weeks, and 8 weeks
The change of hip circumference	The hip circumference will be assessed by measuring tape. Unit: centimeter	Change from Baseline hip circumference at 4 weeks, and 8 weeks
The change of insulin sensitivity	Insulin sensitivity is assessed by HOMA-IR. HOMA-IR= fasting insulin (microU/L) x fasting glucose (nmol/L)/22.5. Venous blood will be sampled to measure concentrations of fasting glycemia and insulin.	Change from Baseline insulin sensitivity at 8 weeks
The change of total cholesterol	Venous blood will be sampled to measure concentrations of total cholesterol.	Change from Baseline total cholesterol at 8 weeks
The change of High Density Lipoprotein Cholesterol (HDL-C)	Venous blood will be sampled to measure concentrations of HDL-C.	Change from Baseline HDL-C at 8 weeks
The change of Low Density Lipoprotein Cholesterol (LDL-C)	Venous blood will be sampled to measure concentrations of LDL-C.	Change from Baseline LDL-C at 8 weeks
The change of triglyceride	Venous blood will be sampled to measure concentrations of triglyceride.	Change from Baseline triglyceride at 8 weeks
The change of intestinal microbiota	Collect subject's feces for bacterial analysis. Intestinal microbiota will be assessed by Next Generation Sequencing (NGS).	Change from Baseline intestinal microbiota at 8 weeks
The change of gastrointestinal tolerability	Gastointestinal tolerability will be assessed by The Gastrointestinal Symptom Rating Scale (GSRS).The GSRS has a seven-point graded Likert-type scale where 1 represents absence of troublesome symptoms and 7 represents very troublesome symptoms.	Change from Baseline gastrointestinal tolerability at 4 weeks, and 8 weeks
The change of stool type	The stool type will be assessed by The Bristol Stool Form Scale (BSFS) daily. The BSFS is a scale that classifies stools, ranging from the hardest (type 1) to the softest (type 7).	Change from Baseline gastrointestinal tolerability at 4 weeks, and 8 weeks

Collaborators and Investigators

• Sponsor: TCI Co., Ltd.
• Investigators: Principal Investigator: Ming-Ta Yang, Taipei Medical University

Study record dates

Study Major Dates

• Study Start (Actual): November 9, 2023
• Primary Completion (Actual): January 30, 2024
• Study Completion (Actual): May 1, 2024

Study Registration Dates

• First Submitted: November 9, 2023
• First Submitted That Met QC Criteria: November 9, 2023
• First Posted (Actual): November 15, 2023

Study Record Updates

• Last Update Posted (Actual): May 6, 2024
• Last Update Submitted That Met QC Criteria: May 3, 2024
• Last Verified: May 1, 2024

More Information

Terms related to this study

• Keywords: Akkermansia muciniphila
• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Insulin Resistance; Hyperinsulinism; Metabolic Syndrome; Body Weight; Body Weight Changes
• Other Study ID Numbers: N202310027

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No