Probiotics in Diabesity: A Pilot Study (Diabesity)
Obesity and type 2 diabetes are a pandemic disease leading to a high morbidity and mortality. Probiotic modulation of gut flora is a possible therapeutic mechanism.
The aim of this study is to investigate and compare thoroughly the effect of a multispecies probiotic on glycaemic control, gut microbiota and gut permeability in patients with metabolic syndrome and diabetes.
研究概览
详细说明
Obesity and diabetes probably represent the most challenging threat to public health in the 21st century. The World Health Organization (WHO) predicts that by 2015 approximately 2.3 billion adults will be overweight (BMI 25-29.9 kg/m²), and more than 700 million will be obese (BMI 30 kg/m² or more). In addition, currently 285 million people worldwide suffer from type 2 diabetes (T2DM), and this number is predicted to increase to 439 million by 2030. T2DM raises the risk for cardiovascular morbidity and mortality, as well as eye problems, nerve damage and kidney diseases. Previous studies demonstrated that the impact of diabetes on everyday life and the likelihood of costly and disabling complications can be reduced by more intensive management of glucose, blood pressure and cholesterol. Weight reduction is the most desired but also most difficult to achieve treatment option in obesity, that is able to prevent secondary complications of obesity and T2DM.
Since weight reduction by diet and increased physical activity alone is difficult to achieve in morbidly obese subjects, other, more aggressive approaches, such as bariatric surgery have been invented.
Recent preclinical and clinical studies have indicated an important influence of the intestinal microbiome (gut metagenome) on obesity and associated metabolic disorders (metabolic syndrome, type 2 diabetes, metabolic liver diseases, cardiovascular diseases). For instance, the cecum microbiota of rodents was found to be significantly different in obese than in lean mice. This finding of altered gut microbiota was then confirmed and extended to humans. Additionally, these investigations in humans demonstrated that as obese people lose weight, the composition of microflora shifted, and more closely resembled that of the lean individuals. This suggests that the microflora might be involved in the pathogenesis of obesity, insulin resistance and T2DM by having an impact on gut permeability and chronic inflammation. Probiotic, prebiotic or synbiotic interventions have been shown to be effective in modulating gut permeability and gut microbiota in animals and thereby modulating chronic inflammation and metabolic disorders in animal models. In humans this has not been shown unequivocally so far.
However, it is yet unknown, who will benefit from which intervention and why individuals respond differently to these interventions.
The aim of this study is to investigate and compare thoroughly the effect of a multispecies probiotic on glycaemic control, gut microbiota and gut permeability in patients with metabolic syndrome and diabetes. The investigators aim to access changes in insulin sensitivity, islet function and the secretion of gut hormones. In addition, the investigators will investigate changes in gut microbiota and gut permeability to understand the underlying mechanism. After investigating the mechanism the overarching aim is to identify biomarkers, which would allow better prediction of treatment success. In future this would allow tailoring obesity and diabetes treatment in order to give every patient the optimal treatment at lowest costs.
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Graz、奥地利、8036
- Medical University of Graz, Department of Internal Medicine
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Participant is willing and able to give informed consent for participation in the study.
- Age above 18 years
- Type 2 diabetes
- BMI 30-40 kg/m²
- HbA1c ≥ 6.5% (48 mmol/mol)
- Stable diabetes therapy over 6 months
- Person commits to the need for long-term follow-up
Exclusion Criteria:
- Type 1 diabetes mellitus
- Maturity Onset Diabetes of the Young (MODY)
- Secondary diabetes due to a specific disease or glucocorticoid therapy
- Pregnancy
- Hypothalamic cause of obesity, Cushing syndrome
- Major psychiatric diseases including diagnosed eating disorders, history of drug or alcohol abuse
- History of bariatric surgery
- Use of probiotics (other than the study product)
- Antibiotic therapy within the last 4 weeks before inclusion
- Inflammatory bowel disease
- Pancreatitis
- Chronic non-steroidal anti-inflammatory drug (NSAID) treatment
- glucagon-like peptide-1 receptor agonist therapy or acarbose therapy
- Recent (less than 12 weeks) acute myocardial infarction or decompensated heart failure
- Recent (less than 12 weeks) stroke
- Known malignancy or any other condition or circumstance, which, in the opinion of the investigator, would affect the patient's ability to participate in the protocol
学习计划
研究是如何设计的?
设计细节
- 主要用途:预防
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:四人间
武器和干预
参与者组/臂 |
干预/治疗 |
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有源比较器:probiotic
Winclove 851 and 110 consist of 6g of a probiotic mixture containing Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Bifidobacterium lactis W51, Lactobacillus acidophilus W37, Lactobacillus brevis W63, Lactobacillus casei W56, Lactobacillus salivarius W24, Lactococcus lactis W19, Lactococcus lactis W58 at a concentration of 2.5 x 109 cfu/g and 10g of a prebiotic mixture of galacto-oligosaccharides P11 (GOS), Fructo-oligosaccharides P6 (FOS), Konjac glucomannan P13 (E425), Maltodextrin, Calcium carbonate (E170), Natural Elderflower flavouring, Gum Arabic (E414), Zinc citrate 3-hydrate, Vitamin D3 (Cholecalciferol) and Vitamin B2 (Riboflavin) (E101) daily for 6 months
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prebiotic and probiotic mixture
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安慰剂比较:placebo
a similar looking and tasting placebo without bacteria
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white powder without pro/probiotic
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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insulin sensitivity
大体时间:12 months
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meal tolerance test
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12 months
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
---|---|---|
gut microbiota composition
大体时间:12 months
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next generation sequencing
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12 months
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gut permeability
大体时间:12 months
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enzyme linked immunosorbent assay
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12 months
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endotoxin
大体时间:12 months
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limulus amoebocyte assay
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12 months
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neutrophil function
大体时间:12 months
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flow cytometry
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12 months
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beta cell function
大体时间:12 months
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meal tolerance test
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12 months
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Quality of Life
大体时间:12 months
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quality of life questionnaire (short form 36, Subscores for 8 domains)
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12 months
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合作者和调查者
调查人员
- 首席研究员:Vanessa Stadlbauer-Köllner, MD、Medical University of Graz
- 首席研究员:Harald Sourij, MD、Medical University of Graz
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- 26-464 ex 13/14
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