The Link Between Obesity And Vitamin D in Bariatric Patients With Omega-loop Bypass Surgery (LOAD)
13. juli 2016 oppdatert av: Maria Luger
The Link Between Obesity And Vitamin D in Bariatric Patients With Omega-loop Bypass Surgery: a Randomized Controlled, Double-blinded Clinical Supplementation Trial
The aim of the study is to increase vitamin D concentrations or to keep it on high level, respectively, by supplementing with vitamin D3 in a different dose regime, and to improve the overall health status in bariatric patients.
In this project, the vitamin D status, the parameters of inflammation, bone turnover, insulin resistance, liver and depression score of bariatric patients are expected to improve, due to supplementation of a loading dose compared to the standard therapy.
Studieoversikt
Status
Fullført
Forhold
Intervensjon / Behandling
Studietype
Intervensjonell
Registrering (Faktiske)
50
Fase
- Fase 4
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
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Vienna, Østerrike, 1090
- Medical University of Vienna
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Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
18 år til 100 år (Voksen, Eldre voksen)
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
Inclusion Criteria:
- Planned omega loop bypass surgery
- 25-hydroxy vitamin D < 75 nmol/l
- BMI >40 or ≥35 kg/m2 with co-morbidities e.g. diabetes mellitus, hypertension
- Body weight <140 kg (due to limitation of DEXA measurement)
- Capability to consent
Exclusion Criteria:
- Another planned form of bariatric surgery
- Hypercalcemia (calcium >2.63 mmol/l) or hypocalcemia (<1.75 mmol/l)
- Renal insufficiency (creatinine >133 μmol/l or GFR <50 ml/min)
- Primary hyperparathyroidism
- Malignancy
- Infection e.g. human immunodeficiency virus
- Medical conditions requiring daily calcium supplements or antacid use
- Known hypersensitivity to cholecalciferol
- No capability to consent
- Imprisoned persons
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Firemannsrom
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
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Aktiv komparator: Intervention
The loading dose of 300 000 IU is divided into three doses (100 000 IU) and will be given over the first months.
All patients in the intervention group will receive the first loading dose of 100 000 IU at day of discharge.
The second (2 weeks) and third (4 weeks postoperative) administration will be given based on the 25-hydroxy vitamin D concentration.
After the last respectively third loading dose a maintenance dose of 3420 IU per day should maintain the high 25-hydroxy vitamin D concentration.
It should be administered for up to 46 weeks (until follow-up visit)
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Placebo komparator: Placebo
The placebo loading dose (oil) is divided into three administrations and will be given over the first months.
All patients in the placebo group will receive the first placebo loading dose at day of discharge.
After the last placebo loading dose a maintenance dose of 3420 IU per day should maintain the 25-hydroxy vitamin D concentration.
It should be administered for up to 46 weeks (until follow-up).
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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25-hydroxy vitamin D levels
Tidsramme: 24 weeks postoperatively
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25-hydroxy vitamin D levels after 24 weeks measured in intervention and placebo group, adjusting for the baseline value as covariate
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24 weeks postoperatively
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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
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Prevalence of sufficient vitamin D
Tidsramme: 24 weeks postoperatively
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Number of patients reaching 25-hydroxyvitamin D levels above 75 nmol/l
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24 weeks postoperatively
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Prevalence of vitamin D deficiency
Tidsramme: 24 weeks postoperatively
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Prevalence of vitamin D deficiency
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24 weeks postoperatively
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Co-morbidities
Tidsramme: 24 weeks postoperatively
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Prevalence of Co-morbidities
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24 weeks postoperatively
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Prescribed medication
Tidsramme: 24 weeks postoperatively
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Change in prescribed medication
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24 weeks postoperatively
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Body weight, body composition
Tidsramme: 24 weeks postoperatively
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Change in body weight and body composition by bioelectrical impedance analysis
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24 weeks postoperatively
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Blood pressure
Tidsramme: 24 weeks postoperatively
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Change of vital signs (blood pressure)
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24 weeks postoperatively
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Laboratory parameters
Tidsramme: 24 weeks postoperatively
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Change in laboratory parameters compared to baseline: vitamin D status, bone turnover markers, calcium homeostasis, parathyroid hormone, inflammation, insulin resistance
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24 weeks postoperatively
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Depression symptoms
Tidsramme: 24 weeks postoperatively
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Prevalence of depression symptoms assessed by Beck Depression Inventory Questionnaire
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24 weeks postoperatively
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Bone mineral density and body fat content
Tidsramme: 24 weeks postoperatively
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Assessment of bone mineral density and total body fat content by DEXA
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24 weeks postoperatively
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Liver condition
Tidsramme: 24 weeks postoperatively
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Measurement of liver stiffness and fat content by FibroScan and CAP
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24 weeks postoperatively
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Dietary assessment
Tidsramme: 24 weeks postoperatively
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Dietary assessment will be documented with a 5-day food record to calculate vitamin D intake and the Mediterranean Score (questionnaire with calculated score)
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24 weeks postoperatively
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Gut microbiota composition
Tidsramme: 24 weeks postoperatively
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Association between vitamin D, gut microbiota and surgery-induced weight loss, by collecting stool samples
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24 weeks postoperatively
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Vitamin D in adipose and liver tissue
Tidsramme: during surgery
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For instance, for the purposes of describing adipose depot vitamin D concentrations and expression of enzymes in subcutaneous, visceral adipose and liver tissue samples will be collected during the omega loop gastric bypass surgery.
Furthermore, the liver tissue samples should be used in addition for a histological examination as extended diagnostics (NAFLD/ NASH).
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during surgery
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Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
Etterforskere
- Hovedetterforsker: Bernhard Ludvik, M.D., Division of Endocrinology & Metabolism, Department of Internal Medicine III, Medical University of Vienna
Publikasjoner og nyttige lenker
Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.
Generelle publikasjoner
- Kruschitz R, Wakolbinger M, Schindler K, Prager G, Hoppichler F, Marculescu R, Ludvik B. Effect of one-anastomosis gastric bypass on cardiovascular risk factors in patients with vitamin D deficiency and morbid obesity: A secondary analysis. Nutr Metab Cardiovasc Dis. 2020 Nov 27;30(12):2379-2388. doi: 10.1016/j.numecd.2020.08.011. Epub 2020 Aug 20.
- Luger M, Kruschitz R, Winzer E, Schindler K, Grabovac I, Kainberger F, Krebs M, Hoppichler F, Langer F, Prager G, Marculescu R, Ludvik B. Changes in Bone Mineral Density Following Weight Loss Induced by One-Anastomosis Gastric Bypass in Patients with Vitamin D Supplementation. Obes Surg. 2018 Nov;28(11):3454-3465. doi: 10.1007/s11695-018-3353-2.
- Luger M, Kruschitz R, Kienbacher C, Traussnigg S, Langer FB, Prager G, Schindler K, Kallay E, Hoppichler F, Trauner M, Krebs M, Marculescu R, Ludvik B. Vitamin D3 Loading Is Superior to Conventional Supplementation After Weight Loss Surgery in Vitamin D-Deficient Morbidly Obese Patients: a Double-Blind Randomized Placebo-Controlled Trial. Obes Surg. 2017 May;27(5):1196-1207. doi: 10.1007/s11695-016-2437-0.
- Luger M, Kruschitz R, Kienbacher C, Traussnigg S, Langer FB, Schindler K, Wurger T, Wrba F, Trauner M, Prager G, Ludvik B. Prevalence of Liver Fibrosis and its Association with Non-invasive Fibrosis and Metabolic Markers in Morbidly Obese Patients with Vitamin D Deficiency. Obes Surg. 2016 Oct;26(10):2425-32. doi: 10.1007/s11695-016-2123-2.
- Luger M, Kruschitz R, Marculescu R, Haslacher H, Hoppichler F, Kallay E, Kienbacher C, Klammer C, Kral M, Langer F, Luger E, Prager G, Trauner M, Traussnigg S, Wurger T, Schindler K, Ludvik B. The link between obesity and vitamin D in bariatric patients with omega-loop gastric bypass surgery - a vitamin D supplementation trial to compare the efficacy of postoperative cholecalciferol loading (LOAD): study protocol for a randomized controlled trial. Trials. 2015 Aug 5;16:328. doi: 10.1186/s13063-015-0877-9.
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart
1. mars 2014
Primær fullføring (Faktiske)
1. oktober 2015
Studiet fullført (Faktiske)
1. juni 2016
Datoer for studieregistrering
Først innsendt
17. mars 2014
Først innsendt som oppfylte QC-kriteriene
19. mars 2014
Først lagt ut (Anslag)
20. mars 2014
Oppdateringer av studieposter
Sist oppdatering lagt ut (Anslag)
14. juli 2016
Siste oppdatering sendt inn som oppfylte QC-kriteriene
13. juli 2016
Sist bekreftet
1. juli 2016
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- LOAD
- 2013-003546-16 (EudraCT-nummer)
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