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Metabolic Effects of Choline and Docosahexaenoic Acid Supplementation in Preterm Infants

9. maj 2018 opdateret af: University Hospital Tuebingen

Nahrungsergänzung Mit Cholin- Und Docosahexaensäure Bei Sehr Unreifen Frühgeborenen

To explore the effects of enteral choline and DHA supplementation on plasma choline and DHA-PC concentrations and metabolism, this randomized controlled study will assign 40 preterm infants to 1 of 4 groups: standard care, choline supplementation, DHA supplementation, and choline and DHA supplementation.

After 7 days of supplementation, a single dose of stable isotope labelled choline will be administered and the kinetics of newly synthesized DHA-PC determined to assess plasma levels, uptake and distribution of choline and DHA.

This study is designed to inform larger studies evaluating this approach of enteral co-application of choline and DHA on clinical important outcomes.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

In utero, there is a constant high supply of choline to the fetus. Preterm delivery disrupts this maternal-fetal choline-transfer. We have shown that choline plasma levels rapidly half after preterm delivery. We also demonstrated that plasma DHA-PC rapidly falls after preterm delivery. DHA supplementation has been evaluated and found safe, however the clinical benefits have been smaller than expected. We speculate that choline deficiency may have contributed to the smaller than expected benefit of DHA supplementation in the past.

This study verifies the hypothesis that concomitant supply of choline and DHA will improve DHA-PC availability and turn-over. This is important because DHA-PC is the transport molecule for the DHA transport to the brain and the retina.

To explore the effects of enteral choline and DHA supplementation on plasma choline and DHA-PC concentrations, this randomized controlled study will assign 40 preterm infants to 1 of 4 groups: standard care, choline supplementation, DHA supplementation, and choline and DHA supplementation.

After 7 days of supplementation, a single dose of stable isotope labelled choline will be administered and the kinetics of newly synthesized DHA-PC determined to assess plasma levels, uptake and distribution of choline and DHA.

This study is designed to inform future larger studies evaluating this approach of enteral co-application of choline and DHA on important clinical outcomes.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

24

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Tyskland
      • Tuebingen, Tyskland, 72076
        • University Hospital of Tuebingen

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

1 uge til 2 måneder (Barn)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • preterm infants with a gestational age at birth between 24 and 32 weeks
  • on almost complete enteral feeding (>75% of total fluid intake)

Exclusion Criteria:

  • insufficient enteral intake,
  • gastrointestinal disease,
  • missing parental consent

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: standard nutrition
Kosttilskud: standard nutrition
standard nutrition
Eksperimentel: choline supplementation
in addition to standard nutrition: enteral supplementation with 30mg/kg choline chloride for 10 days
Kosttilskud: standard nutrition
standard nutrition
Kosttilskud: choline supplementation
in addition to standard nutrition: enteral supplementation with 30mg/kg choline chloride for 10 days
Eksperimentel: DHA supplementation
in addition to standard nutrition: enteral supplementation with 60mg/kg DHA for 10 days
Kosttilskud: standard nutrition
standard nutrition
Kosttilskud: DHA supplementation
in addition to standard nutrition: enteral supplementation with 60mg/kg DHA for 10 days
Eksperimentel: choline and DHA supplementation
in addition to standard nutrition: enteral supplementation with 30mg/kg choline chloride and 60mg/kg of DHA for 10 days
Kosttilskud: standard nutrition
standard nutrition
Kosttilskud: choline supplementation
in addition to standard nutrition: enteral supplementation with 30mg/kg choline chloride for 10 days
Kosttilskud: DHA supplementation
in addition to standard nutrition: enteral supplementation with 60mg/kg DHA for 10 days

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
plasma concentrations of choline
Tidsramme: following 7 days of supplementation
following 7 days of supplementation

Sekundære resultatmål

Resultatmål
Tidsramme
de-novo DHA-phosphatidylcholine synthesis
Tidsramme: following 7 days of supplementation at 12hours after D9-choline administration
following 7 days of supplementation at 12hours after D9-choline administration
DHA-phosphatidylcholine turnover
Tidsramme: following 7.5 days of supplementation, from 12hours to 60 hours after D9-choline administration
following 7.5 days of supplementation, from 12hours to 60 hours after D9-choline administration
fractions and concentrations of molecular species of phosphatidylcholine
Tidsramme: baseline and following 7.5 and 10 days of supplementation
baseline and following 7.5 and 10 days of supplementation
plasma concentrations of choline
Tidsramme: baseline and following 7.5 and 10 days of supplementation
baseline and following 7.5 and 10 days of supplementation
Plasma concentrations of betaine (a metabolite of choline)
Tidsramme: baseline and following 7.5 and 10 days of supplementation
baseline and following 7.5 and 10 days of supplementation
Plasma concentrations of dimethylglycine (a metabolite of choline)
Tidsramme: baseline and following 7.5 and 10 days of supplementation
baseline and following 7.5 and 10 days of supplementation
Plasma concentrations of trimethylamineoxide (TMAO, a metabolite of choline)
Tidsramme: baseline and following 7.5 and 10 days of supplementation
baseline and following 7.5 and 10 days of supplementation

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University Hospital Tuebingen

Efterforskere

  • Ledende efterforsker: Axel Franz, MD, University Hospital Tuebingen

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. juli 2015

Primær færdiggørelse (Faktiske)

31. oktober 2017

Studieafslutning (Faktiske)

31. december 2017

Datoer for studieregistrering

Først indsendt

22. juli 2015

Først indsendt, der opfyldte QC-kriterier

27. juli 2015

Først opslået (Skøn)

28. juli 2015

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

15. maj 2018

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

9. maj 2018

Sidst verificeret

1. maj 2018

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • Choline and DHA for Preemies 2

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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