减肥手术后患者的共生使用
2024年2月1日 更新者:University of North Florida
共生剂对减肥手术患者的胃肠道相关问题是否有帮助?
这项双盲、随机对照试验的目的是通过在给药前和给药后三个月测试粪便样本,测试每天一次的多菌株共生剂对减肥手术患者肠道健康变化的功效。监测粪便样本中细菌的任何变化。
研究参与者还将完成一项调查,评估他们的排便习惯、粪便稠度和胃肠道相关症状。
研究概览
详细说明
感兴趣的主题是肠道微生物组以及共生剂(益生元与益生菌相结合)对减肥手术后肠道健康的影响,因为减肥手术会导致胃和肠道的手术改变。 共生菌可提供积极的肠道健康益处,即。 改善肠道功能并减少胃肠道不适症状,例如腹胀。 然而,在对益生菌/益生元进行文献综述时,大多数研究质量较差,并且没有列出所研究的每种菌株的数量。 迄今为止,尚未对减肥手术后患者的共生给药及其与胃肠道症状改善的关系进行研究。
益生菌没有推荐的标准剂量。 每种菌株的给药剂量均应通过临床试验证明能够有效地为宿主提供健康益处。 然而,尚未建立明确的标准来确定什么分类为有效以及什么健康益处被认为具有临床相关性。 大多数医疗机构建议成人每天使用 1 至 20 x 109 菌落形成单位 (CFU)。 在许多情况下,较高剂量已被证明更有效,但尚未确定明确的剂量依赖性反应,并且“越多越好”的理念并不适用于所有菌株。 因此,一条规则规定“如果产品包含多种菌株,则每种菌株的含量应为 109,以确保有效性”。
本研究的主要目的是确定共生给药对改善减肥手术患者胃肠道健康的功效。 这项研究将测试每天一次的多菌株共生菌对减肥手术患者术后十二个月或更长时间肠道健康变化的功效,方法是在给药前检测粪便样本,然后在共生菌给药后三个月进行监测粪便样本中细菌的任何变化。 研究参与者还将完成一项调查,评估他们在共生给药前后的排便习惯、粪便稠度和胃肠道症状。
研究类型
介入性
注册 (估计的)
110
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。
学习联系方式
- 姓名:Samantha Stavola-Giaconia, MHA
- 电话号码:215-806-2792
- 邮箱:sam@celebratevitamins.com
研究联系人备份
- 姓名:Andrea Arikawa, PhD
- 电话号码:904-620-1433
- 邮箱:a.arikawa@unf.edu
学习地点
-
-
Florida
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Jacksonville、Florida、美国、32224
- 招聘中
- University of North Florida
-
接触:
- Andrea Y Arikawa, PhD
- 电话号码:904-620-1433
- 邮箱:a.arikawa@unf.edu
-
接触:
- Nicole Sayers
- 电话号码:904-620-2498
- 邮箱:irb@unf.edu
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首席研究员:
- Andrea Y Arikawa, PhD
-
-
参与标准
研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
是的
描述
纳入标准:
- 吸收不良减肥手术后 12 个月或更长时间
排除标准:
- 由于缺乏肠道手术改变而使用 LapBand 或胃内气球的患者
- 尚未获得批准的减肥程序的个人
- 胃肠功能受损的人士,会影响口服补充剂的摄入
- 胃肠功能受损的人士,会影响收集粪便样本的能力
- 无法理解和完成评估工具
- 无法坚持服用 90 天胶囊补充剂
- 目前每天服用益生菌、益生元或共生补充剂
- 目前正在接受医生的抗生素治疗
学习计划
本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。
研究是如何设计的?
设计细节
- 主要用途:治疗
- 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 |
|---|---|
|
实验性的:共生集团
一种非处方、每日一次的共生胶囊,包含:150 亿 CFU 益生菌混合物和 250 毫克益生元。
|
每日服用一粒胶囊补充剂,其中含有:150 亿 CFU 益生菌混合物(嗜酸乳杆菌 La-14、长双歧杆菌 BB536、嗜酸乳杆菌 NCFM、鼠李糖乳杆菌 GG、加氏乳杆菌 Lg-36)和 250 毫克菊苣根菊粉。
其他名称:
|
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安慰剂比较:纤维集团
每日一次微晶纤维素胶囊。
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含有微晶纤维素的日用纤维胶囊
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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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粪便样本的共生变化
大体时间:90天
|
主要目标是通过在给药前以及共生剂或安慰剂给药后三个月内测试粪便样本,来测试每天一次的多菌株共生剂对减肥手术患者肠道健康变化的功效。
将进行卡方检验以显示共生摄入量与粪便细菌多样性和浓度之间的关联。
|
90天
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
布里斯托大便量表每周变化
大体时间:12周
|
参与者将每周完成一次布里斯托尔粪便量表,以确定他们本周的整体粪便稠度。参与者将每周完成此工具,并使用 SPSS 软件对平均变化进行独立 t 检验,以评估粪便形状的差异。
总分范围为 7 至 49,最接近 24.5 的分数代表正常粪便形式。
这些测试的比较将能够提供正常粪便形式中共生补充剂的使用的统计相关性。
|
12周
|
|
每周大便频率
大体时间:12周
|
参与者将完成每周一次的调查,以确定前一周产生的粪便量。
将进行独立 t 检验以显示排便频率的变化。
|
12周
|
|
胃肠道相关症状
大体时间:12周
|
将使用 SPSS 软件进行最终的卡方关联检验,以测试共生摄入量与胃肠道相关症状的减少之间是否存在关系。
0.05 或更低的 P 值将用于证明所进行的所有测试的统计显着性。
|
12周
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Ouwehand AC. A review of dose-responses of probiotics in human studies. Benef Microbes. 2017 Apr 26;8(2):143-151. doi: 10.3920/BM2016.0140. Epub 2016 Dec 23.
- Anderson JW, Baird P, Davis RH Jr, Ferreri S, Knudtson M, Koraym A, Waters V, Williams CL. Health benefits of dietary fiber. Nutr Rev. 2009 Apr;67(4):188-205. doi: 10.1111/j.1753-4887.2009.00189.x.
- Woodard GA, Encarnacion B, Downey JR, Peraza J, Chong K, Hernandez-Boussard T, Morton JM. Probiotics improve outcomes after Roux-en-Y gastric bypass surgery: a prospective randomized trial. J Gastrointest Surg. 2009 Jul;13(7):1198-204. doi: 10.1007/s11605-009-0891-x. Epub 2009 Apr 18.
- Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018. NCHS Data Brief. 2020 Feb;(360):1-8.
- Ward ZJ, Bleich SN, Cradock AL, Barrett JL, Giles CM, Flax C, Long MW, Gortmaker SL. Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity. N Engl J Med. 2019 Dec 19;381(25):2440-2450. doi: 10.1056/NEJMsa1909301.
- Mechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, Kim J, Kushner RF, Lindquist R, Pessah-Pollack R, Seger J, Urman RD, Adams S, Cleek JB, Correa R, Figaro MK, Flanders K, Grams J, Hurley DL, Kothari S, Seger MV, Still CD. CLINICAL PRACTICE GUIDELINES FOR THE PERIOPERATIVE NUTRITION, METABOLIC, AND NONSURGICAL SUPPORT OF PATIENTS UNDERGOING BARIATRIC PROCEDURES - 2019 UPDATE: COSPONSORED BY AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY, THE OBESITY SOCIETY, AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY, OBESITY MEDICINE ASSOCIATION, AND AMERICAN SOCIETY OF ANESTHESIOLOGISTS - EXECUTIVE SUMMARY. Endocr Pract. 2019 Dec;25(12):1346-1359. doi: 10.4158/GL-2019-0406. Epub 2019 Nov 4.
- Arterburn DE, Telem DA, Kushner RF, Courcoulas AP. Benefits and Risks of Bariatric Surgery in Adults: A Review. JAMA. 2020 Sep 1;324(9):879-887. doi: 10.1001/jama.2020.12567.
- Lim Y, Boster J. Obesity and Comorbid Conditions. StatPearls. Published online October 25, 2021. Accessed March 28, 2022. https://www.ncbi.nlm.nih.gov/books/NBK574535/
- Obesity Medicine Association. AMA Classifies Obesity as a Disease | Obesity Medicine AssociationMain. Published June 19, 2013. Accessed May 2, 2022.
- Bhutani S, vanDellen MR, Cooper JA. Longitudinal Weight Gain and Related Risk Behaviors during the COVID-19 Pandemic in Adults in the US. Nutrients. 2021 Feb 19;13(2):671. doi: 10.3390/nu13020671.
- Kim J, Eisenberg D, Azagury D, Rogers A, Campos GM. American Society for Metabolic and Bariatric Surgery position statement on long-term survival benefit after metabolic and bariatric surgery. Surg Obes Relat Dis. 2016 Mar-Apr;12(3):453-459. doi: 10.1016/j.soard.2015.11.021. Epub 2015 Nov 27.
- American Society of Metabolic and Bariatric Surgery. Access to Care Fact Sheet. Published 2011. Accessed March 29, 2022. https://asmbs.org/resources/access-to-care-fact-sheet
- Eisenberg D, Shikora SA, Aarts E, Aminian A, Angrisani L, Cohen RV, De Luca M, Faria SL, Goodpaster KPS, Haddad A, Himpens JM, Kow L, Kurian M, Loi K, Mahawar K, Nimeri A, O'Kane M, Papasavas PK, Ponce J, Pratt JSA, Rogers AM, Steele KE, Suter M, Kothari SN. 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for Metabolic and Bariatric Surgery. Surg Obes Relat Dis. 2022 Dec;18(12):1345-1356. doi: 10.1016/j.soard.2022.08.013. Epub 2022 Oct 21.
- Carter J, Chang J, Birriel TJ, Moustarah F, Sogg S, Goodpaster K, Benson-Davies S, Chapmon K, Eisenberg D. ASMBS position statement on preoperative patient optimization before metabolic and bariatric surgery. Surg Obes Relat Dis. 2021 Dec;17(12):1956-1976. doi: 10.1016/j.soard.2021.08.024. Epub 2021 Sep 3. No abstract available.
- Youdim A. Bariatric Surgery. Merck Manual Professional Version. Published August 2021. Accessed April 17, 2022. https://www.merckmanuals.com/professional/nutritional-disorders/obesity-and-the-metabolic-syndrome/bariatric-surgery
- Stefater MA, Wilson-Perez HE, Chambers AP, Sandoval DA, Seeley RJ. All bariatric surgeries are not created equal: insights from mechanistic comparisons. Endocr Rev. 2012 Aug;33(4):595-622. doi: 10.1210/er.2011-1044. Epub 2012 May 1.
- Center for Disease Control and Prevention. Adult Obesity Facts. Published September 30, 2021. Accessed March 28, 2022. https://www.cdc.gov/obesity/data/adult.html
- Owens DK. Interpretation of cost-effectiveness analyses. J Gen Intern Med. 1998 Oct;13(10):716-7. doi: 10.1046/j.1525-1497.1998.00211.x. No abstract available.
- Weight Management Dietetic Practice Group. Pocket Guide to Bariatric Surgery. Third Edition. (Isom KA, Majumdar MC, eds.).; 2022.
- International Federation of Surgery for Obesity. Gastric Bypass Surgery. Accessed April 12, 2022. https://www.ifso.com/roux-en-y-gastric-bypass/
- International Federation of Surgery for Obesity. Biliopancreatic Diversion. Accessed April 12, 2022. https://www.ifso.com/bilio-pancreatic-diversion-with-duodenal-switch/
- International Federation of Surgery for Obesity. Laparoscopic Single Anastomosis Duodenal-Ileal bypass with Sleeve (SADI-S). Accessed April 12, 2022. https://www.ifso.com/single-anastomosis-duodenal-Ileal-bypass-with-sleeve/
- American Society for Metabolic and Bariatric Surgery. Estimate of Bariatric Surgery Numbers, 2011-2019. Published March 2021. Accessed April 11, 2022.
- Tabesh MR, Maleklou F, Ejtehadi F, Alizadeh Z. Nutrition, Physical Activity, and Prescription of Supplements in Pre- and Post-bariatric Surgery Patients: a Practical Guideline. Obes Surg. 2019 Oct;29(10):3385-3400. doi: 10.1007/s11695-019-04112-y. Erratum In: Obes Surg. 2020 Feb;30(2):793.
- Lysen LK, Isreal DA. Nutrition in Weight Management. In: Mahan KL, Escott-Stump S, Raymond JL, eds. Krause's Food and Nutrition Care Process. 13th ed. Elsevier; 2012:462-488.
- Sherf Dagan S, Goldenshluger A, Globus I, Schweiger C, Kessler Y, Kowen Sandbank G, Ben-Porat T, Sinai T. Nutritional Recommendations for Adult Bariatric Surgery Patients: Clinical Practice. Adv Nutr. 2017 Mar 15;8(2):382-394. doi: 10.3945/an.116.014258. Print 2017 Mar.
- Sawaya RA, Jaffe J, Friedenberg L, Friedenberg FK. Vitamin, mineral, and drug absorption following bariatric surgery. Curr Drug Metab. 2012 Nov;13(9):1345-55. doi: 10.2174/138920012803341339.
- Sherf-Dagan S, Buch A, Ben-Porat T, Sakran N, Sinai T. Vitamin E status among bariatric surgery patients: a systematic review. Surg Obes Relat Dis. 2021 Apr;17(4):816-830. doi: 10.1016/j.soard.2020.10.029. Epub 2020 Nov 10.
- World Gastroenterology Organisation (WGO). WGO Practice Guidelines Probiotics and Prebiotics. February 2017. https://www.worldgastroenterology.org/guidelines/probiotics-and-prebiotics
- International Scientific Association for Probiotics and Prebiotics. The ISAPP quick guide to probiotics for health professionals: History, efficacy, and safety. December, 2019. https://isappscience.org/for-clinicians/resources/probiotics/#toggle-id-1
- Sweeney TE, Morton JM. The human gut microbiome: a review of the effect of obesity and surgically induced weight loss. JAMA Surg. 2013 Jun;148(6):563-9. doi: 10.1001/jamasurg.2013.5.
- Zhang Y, Yan T, Xu C, Yang H, Zhang T, Liu Y. Probiotics Can Further Reduce Waist Circumference in Adults with Morbid Obesity after Bariatric Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2021 Apr 1;2021:5542626. doi: 10.1155/2021/5542626. eCollection 2021.
- Wang Y, Wu XT, Chen J. Effect of Probiotic Supplementation on Weight Loss, Inflammatory Factors, and Metabolic Effects in Patients Undergoing Bariatric Surgery. Obes Surg. 2022 May;32(5):1779-1782. doi: 10.1007/s11695-022-05974-5. Epub 2022 Mar 4. No abstract available.
- Seganfredo FB, Blume CA, Moehlecke M, Giongo A, Casagrande DS, Spolidoro JVN, Padoin AV, Schaan BD, Mottin CC. Weight-loss interventions and gut microbiota changes in overweight and obese patients: a systematic review. Obes Rev. 2017 Aug;18(8):832-851. doi: 10.1111/obr.12541. Epub 2017 May 19.
- Farup PG, Valeur J. Changes in Faecal Short-Chain Fatty Acids after Weight-Loss Interventions in Subjects with Morbid Obesity. Nutrients. 2020 Mar 18;12(3):802. doi: 10.3390/nu12030802.
- Zhang H, DiBaise JK, Zuccolo A, Kudrna D, Braidotti M, Yu Y, Parameswaran P, Crowell MD, Wing R, Rittmann BE, Krajmalnik-Brown R. Human gut microbiota in obesity and after gastric bypass. Proc Natl Acad Sci U S A. 2009 Feb 17;106(7):2365-70. doi: 10.1073/pnas.0812600106. Epub 2009 Jan 21.
- Fouladi F, Brooks AE, Fodor AA, Carroll IM, Bulik-Sullivan EC, Tsilimigras MCB, Sioda M, Steffen KJ. The Role of the Gut Microbiota in Sustained Weight Loss Following Roux-en-Y Gastric Bypass Surgery. Obes Surg. 2019 Apr;29(4):1259-1267. doi: 10.1007/s11695-018-03653-y.
- Zuo HJ, Xie ZM, Zhang WW, Li YR, Wang W, Ding XB, Pei XF. Gut bacteria alteration in obese people and its relationship with gene polymorphism. World J Gastroenterol. 2011 Feb 28;17(8):1076-81. doi: 10.3748/wjg.v17.i8.1076.
- Aron-Wisnewsky J, Prifti E, Belda E, Ichou F, Kayser BD, Dao MC, Verger EO, Hedjazi L, Bouillot JL, Chevallier JM, Pons N, Le Chatelier E, Levenez F, Ehrlich SD, Dore J, Zucker JD, Clement K. Major microbiota dysbiosis in severe obesity: fate after bariatric surgery. Gut. 2019 Jan;68(1):70-82. doi: 10.1136/gutjnl-2018-316103. Epub 2018 Jun 13.
- Calikoglu F, Barbaros U, Uzum AK, Tutuncu Y, Satman I. The Metabolic Effects of Pre-probiotic Supplementation After Roux-en-Y Gastric Bypass (RYGB) Surgery: a Prospective, Randomized Controlled Study. Obes Surg. 2021 Jan;31(1):215-223. doi: 10.1007/s11695-020-04894-6. Epub 2020 Aug 15.
- Kazzi F, Daher N, Zimmerman G, Garcia M, Schmidt N, Scharf K. Effect of Bacillius Coagulans and Galactomannans on Obese Patients Undergoing Sleeve Gastrectomy, A Randomized-Controlled Clinical Trial. Altern Ther Health Med. 2021 Jun;27(S1):138-145.
- Shoaib M, Shehzad A, Omar M, Rakha A, Raza H, Sharif HR, Shakeel A, Ansari A, Niazi S. Inulin: Properties, health benefits and food applications. Carbohydr Polym. 2016 Aug 20;147:444-454. doi: 10.1016/j.carbpol.2016.04.020. Epub 2016 Apr 8.
- Sinn DH, Song JH, Kim HJ, Lee JH, Son HJ, Chang DK, Kim YH, Kim JJ, Rhee JC, Rhee PL. Therapeutic effect of Lactobacillus acidophilus-SDC 2012, 2013 in patients with irritable bowel syndrome. Dig Dis Sci. 2008 Oct;53(10):2714-8. doi: 10.1007/s10620-007-0196-4. Epub 2008 Feb 15.
- Maria Remes Troche J, Coss Adame E, Angel Valdovinos Diaz M, Gomez Escudero O, Eugenia Icaza Chavez M, Antonio Chavez-Barrera J, Zarate Mondragon F, Antonio Ruiz Velarde Velasco J, Rafael Aceves Tavares G, Antonio Lira Pedrin M, Cerda Contreras E, Carmona Sanchez RI, Guerra Lopez H, Solana Ortiz R. Lactobacillus acidophilus LB: a useful pharmabiotic for the treatment of digestive disorders. Therap Adv Gastroenterol. 2020 Nov 24;13:1756284820971201. doi: 10.1177/1756284820971201. eCollection 2020.
- Kailasapathy K, Chin J. Survival and therapeutic potential of probiotic organisms with reference to Lactobacillus acidophilus and Bifidobacterium spp. Immunol Cell Biol. 2000 Feb;78(1):80-8. doi: 10.1046/j.1440-1711.2000.00886.x.
- Preston K, Krumian R, Hattner J, de Montigny D, Stewart M, Gaddam S. Lactobacillus acidophilus CL1285, Lactobacillus casei LBC80R and Lactobacillus rhamnosus CLR2 improve quality-of-life and IBS symptoms: a double-blind, randomised, placebo-controlled study. Benef Microbes. 2018 Sep 18;9(5):697-706. doi: 10.3920/BM2017.0105. Epub 2018 Jun 11.
- Picard C, Fioramonti J, Francois A, Robinson T, Neant F, Matuchansky C. Review article: bifidobacteria as probiotic agents -- physiological effects and clinical benefits. Aliment Pharmacol Ther. 2005 Sep 15;22(6):495-512. doi: 10.1111/j.1365-2036.2005.02615.x.
- Bouvier M, Meance S, Bouley C, Berta JL, Grimaud JC. Effects of consumption of a milk fermented by the probiotic strain Bifidobacterium animalis DN-173 010 on colonic transit times in healthy humans. Bioscience Microflora 2001; 20: 43-48.
- Ringel-Kulka T, McRorie J, Ringel Y. Multi-Center, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study to Evaluate the Benefit of the Probiotic Bifidobacterium infantis 35624 in Non-Patients With Symptoms of Abdominal Discomfort and Bloating. Am J Gastroenterol. 2017 Jan;112(1):145-151. doi: 10.1038/ajg.2016.511. Epub 2016 Nov 15.
- Kligler B, Cohrssen A. Probiotics. Am Fam Physician. 2008 Nov 1;78(9):1073-8.
- Probiotics: Fact Sheet for Health Professionals. National Institute of Health Office of Dietary Supplements.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2024年1月8日
初级完成 (估计的)
2024年8月1日
研究完成 (估计的)
2024年12月1日
研究注册日期
首次提交
2024年2月1日
首先提交符合 QC 标准的
2024年2月1日
首次发布 (估计的)
2024年2月9日
研究记录更新
最后更新发布 (估计的)
2024年2月9日
上次提交的符合 QC 标准的更新
2024年2月1日
最后验证
2024年2月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.