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High-Protein Diet for Improving Alcoholic Fatty Liver Disease (HP-AFLD-RCT)

24 juni 2026 bijgewerkt door: Li Lab,MD

Efficacy and Safety of a High-Protein Diet Versus a Standard Diet in Patients With Alcoholic Fatty Liver Disease: A Randomized Controlled Trial

Alcohol-associated liver disease (ALD) is a major cause of mortality from malignant liver diseases, accounting for 47.9% of cirrhosis-related deaths and 30% of liver cancer-related deaths annually. In China, both alcohol consumption and the prevalence of ALD (approximately 5.15%) are on the rise, making ALD an increasingly significant health concern for the population. Alcohol-associated fatty liver disease (AFLD), as the initial and most reversible stage of ALD, is primarily characterized by excessive hepatic lipid deposition, mild liver injury accompanied by mild inflammation. It can progressively develop into alcoholic hepatitis, and in some patients, advance to liver fibrosis, cirrhosis, and even hepatocellular carcinoma. Currently, there is a lack of effective clinical treatments for AFLD. Although alcohol abstinence remains the optimal choice for reversing AFLD, it is often difficult for individuals with alcohol dependence to maintain.

A high-protein diet generally refers to a dietary pattern where protein accounts for more than 20% of total energy intake. A protein contribution of 30% is a common ratio in research investigating high-protein dietary interventions for metabolic diseases. Population-based intervention studies have demonstrated that a high-protein diet at this ratio significantly reduces hepatic fat content. For instance, a study published in Gastroenterology (2017) reported that a 6-week isocaloric high-protein diet (macronutrient distribution: 30% protein, 40% carbohydrates, 30% fat) significantly improved hepatic lipid deposition in patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). Research in Diabetologia (2019) showed that a 6-week isocaloric high-protein diet (30% protein, 30% carbohydrates, 40% fat) significantly reduced hepatic fat content in patients with T2DM. Additionally, a study in Liver International (2020) indicated that a 3-week energy-restricted high-protein diet (30% protein, 35%-45% carbohydrates, 25%-30% fat) significantly decreased hepatic fat content in NAFLD patients. Importantly, none of the aforementioned studies reported adverse events associated with the high-protein dietary interventions. Furthermore, a population-based intervention study published in Annals of Internal Medicine revealed that a low-carbohydrate, high-fat diet was more effective than a high-carbohydrate, low-fat diet in reducing hepatic fat content over a 6-month period in patients with NAFLD and T2DM. These findings suggest that increasing the percentage of energy from protein by reducing carbohydrate intake may yield superior improvements. Based on the macronutrient distributions from the referenced population interventions, and considering that a 30% fat energy contribution closely aligns with the typical dietary fat intake of the Chinese AFLD population, we established the macronutrient distribution for the high-protein diet group as 30% protein, 40% carbohydrates, and 30% fat.

This study intends to conduct a randomized controlled trial to investigate the effects of increasing the percentage of energy from protein under an isocaloric dietary pattern on liver function, hepatic fat content, and glucose-lipid metabolism in individuals with AFLD. The aim is to elucidate the mechanisms underlying its beneficial effects on AFLD, thereby providing population-based evidence and strategies for health promotion in this patient group.

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Interventie / Behandeling

Studietype

Ingrijpend

Inschrijving (Geschat)

74

Fase

  • Fase 2
  • Fase 1

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Beschrijving

Inclusion Criteria:

  1. Aged between 30 and 65 years old.
  2. Able to understand the study and voluntarily sign the informed consent form.
  3. Meet the clinical diagnostic criteria for alcohol-associated fatty liver disease (AFLD): a history of alcohol consumption for ≥5 years, with an average daily ethanol intake of ≥20 g/d; clinically diagnosed with fatty liver (indicated by abdominal ultrasound or a liver MRI proton density fat fraction [MRI-PDFF] ≥5.2%).

Exclusion Criteria:

  1. Average daily ethanol intake >80 g/d.
  2. Presence of other hepatobiliary diseases, such as autoimmune liver disease, viral hepatitis, liver fibrosis, or cirrhosis.
  3. Presence of severe cardiovascular or cerebrovascular diseases, or renal insufficiency.
  4. Patients with tumors or other severe systemic diseases.
  5. Patients with gastrointestinal disorders, or those with known protein allergy or intolerance.
  6. Long-term use of medications known to cause hepatic steatosis or steatohepatitis (e.g., amiodarone or tamoxifen), nutritional supplements, or probiotics.
  7. Total daily energy intake (excluding energy from alcohol) <1900 kcal or ≥2900 kcal.
  8. Participation in another interventional study within the past year, or scheduled to receive non-study treatments during the trial period.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Verviervoudigen

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: high protein diet group
Arm Description: High-protein meals will be provided for 6 days per week, and high-protein recipes will be provided for the remainder of the week.
high protein diet
Placebo-vergelijker: control diet group
Control meals will be provided for 6 days per week, and control recipes will be provided for the remainder of the week.
control diet
Experimenteel: perilla peptide dietary group
The perilla peptide alternative maintains the same total protein intake by partially replacing conventional protein sources with hydrolyzed vegetable protein.
perilla peptide dietary group

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Magnetic Resonance Imaging proton density fat fraction in hepatic steatosis
Tijdsspanne: Baseline, up to 60 days of the study
Magnetic Resonance Imaging (MRI) technology utilizes magnetic fields and radiofrequency pulses to conduct non-invasive examinations of tissues. When measuring liver fat content, MRI employs water-fat separation techniques to quantify the proton density of water molecules and fat molecules (PDFF) within the liver, thereby providing a quantitative analysis of fat content.
Baseline, up to 60 days of the study

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Liver function
Tijdsspanne: Baseline, up to 60 days of the study
Alanine aminotransferase (ALT, U/L), aspartate aminotransferase (AST, U/L), γ-glutamyltransferase (γ-GT, U/L), alkaline phosphatase (ALP, U/L), total bilirubin (TBIL, μmol/L), direct bilirubin (DBIL, μmol/L), indirect bilirubin (IBIL, μmol/L), alcohol dehydrogenase (ADH, U/L), aldehyde dehydrogenase (ALDH, U/L).
Baseline, up to 60 days of the study
Glucose metabolism
Tijdsspanne: Baseline, up to 60 days of the study
Hemoglobin A1c (HbA1c, %), Fasting blood glucose (FBG, mmol/L)
Baseline, up to 60 days of the study
Lipid metabolism
Tijdsspanne: Baseline, up to 60 days of the study
Serum triglycerides (TG, mmol/L), total cholesterol (TC, mmol/L), low-density lipoprotein cholesterol (LDL-C, mmol/L), high-density lipoprotein cholesterol (HDL-C, mmol/L), apolipoprotein A-I (ApoA-I, g/L), apolipoprotein B (Apo B, g/L).
Baseline, up to 60 days of the study

Andere uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Inflammation level
Tijdsspanne: Baseline, up to 60 days of the study
High-sensitivity C-reactive protein (hs-CRP, mg/L), tumor necrosis factor (TNF-α, pg/mL), interleukins (IL-1β, pg/mL), interleukins (IL-6, pg/mL).
Baseline, up to 60 days of the study
Kidney function
Tijdsspanne: Baseline, up to 60 days of the study
Blood creatinine (CREA, μmol/L), urea nitrogen (BUN, mmol/L), uric acid (UA, μmol/L).
Baseline, up to 60 days of the study
Intestinal flora
Tijdsspanne: Baseline, up to 60 days of the study
16s rRNA sequencing
Baseline, up to 60 days of the study
serum untargeted metabolomics
Tijdsspanne: Baseline, up to 60 days of the study
serum untargeted metabolomics
Baseline, up to 60 days of the study
biomarkers of oxidative stress
Tijdsspanne: Baseline, up to 60 days of the study
Urinary 8-isoprostane(pg/mL)
Baseline, up to 60 days of the study

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Medewerkers

Onderzoekers

  • Studie stoel: Songtao Li, Zhejiang Chinese Medical University
  • Studie stoel: Rennan Ren, Harbin Medical University

Publicaties en nuttige links

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Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 juli 2026

Primaire voltooiing (Geschat)

31 december 2026

Studie voltooiing (Geschat)

31 december 2027

Studieregistratiedata

Eerst ingediend

29 mei 2026

Eerst ingediend dat voldeed aan de QC-criteria

4 juni 2026

Eerst geplaatst (Werkelijk)

8 juni 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

29 juni 2026

Laatste update ingediend die voldeed aan QC-criteria

24 juni 2026

Laatst geverifieerd

1 juni 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • HP-AFLD-RCT

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Beschrijving IPD-plan

Protect volunteers' personal health data and personal privacy

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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