肠易激综合症和控制志愿者:饮食挑战
肠易激综合征 (IBS) 患者和对照志愿者的粪便胆汁酸、粪便短链脂肪酸和肠道微生物群:饮食挑战
该研究将探讨肠易激综合征 (IBS) 中粪便胆汁酸、短链脂肪酸 (SCFA) 和肠道微生物群之间的关系。 这项研究的中心假设是,胃肠道微生物组组成的特定变化与结肠 SCFA 和 BA 的改变相关,并导致 IBS 症状。 主要目标包括:(a) 识别 IBS 亚型(IBS-C 和 IBS-D)和匹配对照中的胃肠道微生物组特征,并测试这些组中的微生物组特征是否与粪便 SCFA 和难消化碳水化合物(菊粉)的细菌发酵相关。饮食挑战(粪便菊粉),以及 (b) 确定 IBS 亚型和对照中的胃肠道微生物特征是否与粪便 BA 或 SCFA 产生标记物(粪便 SCFA 或菊粉)相关,并测试 BA 是否与粪便 SCFA 或菊粉相关。
目标人群是年龄 18-65 岁、符合 IBS 罗马 IV 标准(腹泻和便秘为主,IBS-D 和 IBS-C)和无症状对照的成年人。 主要结果是粪便胆汁酸排泄和分布、短链脂肪酸排泄和分布、结肠转运和粪便微生物群。 次要结果是基于对经过验证的肠道日记的反应的粪便特征。 在为期 4 天的 100 克脂肪饮食的最后 2 天,将从参与者身上收集粪便样本,并将其分为 3 个样本,用于粪便微生物群、短链脂肪酸 (SCFA) 和胆汁酸分析。
研究概览
详细说明
学习期间:
筛选/参观1
- 在对有关研究的所有问题都得到满意答复后,将要求参与者阅读并签署此知情同意书。
- 这是一次筛选访问,我们可能会确定参与者没有资格继续参与研究。
- 研究小组将收集药物和病史。
- 医生将进行身体检查。 将收集生命体征和身体测量数据。
- 参与者将获得一份带回家的烤宽面条餐(素食和非素食选项)和甜点。
- 参与者将收到粪便收集套件以及粪便收集、储存和运输的说明。
- 将提供第 2-4 天低纤维、高脂肪饮食的说明。
- 参与者将被要求使用 ASA24 和肠道模式日记来完成饮食回忆,以记录研究过程中的肠道症状。
- IBS 参与者将完成肠易激综合征严重程度评分系统调查问卷 (IBS-SSS)。
第 2-4 天(在家):
- 参与者将每天在日记中记录大便症状和模式。
- 参与者将被指导采取低纤维饮食(每天最多吃一份水果和 100 克蔬菜,用白面粉代替全谷物产品),避免饮酒,并开始为期 4 天的 100 克脂肪饮食。
- 在第 5 天的前一天晚上,参与者将被指示在家中收集粪便样本,并在第 2 次访视期间返回。
第 5 天(访问 2):
- 参与者将在禁食过夜后于第五天返回诊所。
- 育龄范围内的参与者将在摄入菊粉之前进行尿妊娠测试,研究小组将确认阴性测试结果。
- 与会者将在现场享用早餐。 非素食选项包括煎饼、黄油、糖浆、煮鸡蛋和培根。 素食选项将用奶酪零食(约 790 至 840 kcal)和 10 克菊粉 Orafti® 粉末(在 200 毫升水中充分混合)代替培根。
- 午餐和晚餐将提供带回家的餐点,并应在早餐后 4 小时和 8 小时内食用。
- IBS 参与者将完成肠易激综合征严重程度评分系统 (IBS-SSS) 调查问卷。
- 将在第 5 天收集粪便样本。
- 参与者将继续使用 ASA24 和肠道模式日记来完成饮食回忆,以记录研究过程中的肠道症状。
第六天
- 将指示参与者收集最终粪便样本(第 6 天)。
- 参与者将继续使用 ASA24 和肠道模式日记来完成饮食回忆,以记录研究过程中的肠道症状。
第 7 天(访问 3)
• 参与者将返回诊所归还粪便收集品(第5 天和第6 天)、每日日记和IBS-SSS 表格(如果适用)。
第 30-90 天(可选饮食跟进):为了进一步评估 24 小时饮食回忆的效用,愿意的参与者将被邀请参加一项可选的后续活动,在此期间他们将完成自动自我管理饮食有或没有受过训练的访谈员协助的评估工具。 研究团队将通过电话联系感兴趣的志愿者,并提供如何在线完成该工具的说明。
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习地点
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California
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Los Angeles、California、美国、90095
- 招聘中
- University of California, Los Angeles
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首席研究员:
- Andrea S Shin
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接触:
- Ren Cutrer
- 电话号码:(310) 794-9507
- 邮箱:rcutrer@mednet.ucla.edu
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
纳入标准:
- 年龄18-75岁
- 肠易激综合症 (IBS) 患者
- 既往无胃肠道 (GI) 疾病或症状的健康志愿者(健康对照)
- 除素食外没有饮食限制
排除标准:
- 炎症性肠病、乳糜泻或某些类型的腹部癌症,以及患有甲状腺或肝脏问题的患者
- 参与研究后 6 个月内进行过腹部手术或腹部放射治疗,剖腹产或胆囊切除除外
- 健康志愿者在参与研究前 6 个月内,或参与研究后 2 天内使用任何已知会影响胃肠道功能或研究解释的处方药、非处方药或草药,例如阿片类药物、炎症药物或某些抗抑郁药患有肠易激综合症的参与者。
- 对于服用稳定低剂量抗抑郁药超过一个月的个人来说,允许有限使用。
- 必要时允许使用比沙可啶 (dulcolax) 等救援药物来缓解严重便秘并收集粪便。
- 使用臭氧和臭氧类药物
- 孕妇或哺乳期妇女
- 参与研究后 3 个月内使用抗生素
- 研究开始前 2 周内使用益生元或益生菌
- 过去 6 个月内经常吸烟
学习计划
研究是如何设计的?
设计细节
- 主要用途:诊断
- 分配:非随机化
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的:健康志愿者
没有胃肠道疾病或症状的 18-65 岁的成年人。
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菊糖摄入不用于诊断、治疗或预防 IBS。
菊糖被用于研究个体发酵膳食纤维的能力。
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实验性的:伴有腹泻的肠易激综合症患者 (IBS-D)
伴有腹泻的肠易激综合征 (IBS) 患者,年龄 18-65 岁,符合 IBS 罗马 IV 标准。
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菊糖摄入不用于诊断、治疗或预防 IBS。
菊糖被用于研究个体发酵膳食纤维的能力。
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实验性的:便秘型肠易激综合症患者 (IBS-C)
患有便秘的肠易激综合征 (IBS) 患者,年龄 18-65 岁,符合 IBS 罗马 IV 标准。
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菊糖摄入不用于诊断、治疗或预防 IBS。
菊糖被用于研究个体发酵膳食纤维的能力。
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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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总粪便短链脂肪酸
大体时间:48小时
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将收集粪便样本,用于通过液相色谱-质谱法测量短链脂肪酸 (µg/mg)
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48小时
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个体粪便短链脂肪酸
大体时间:48小时
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将收集粪便样本,用于通过液相色谱-质谱法测量短链脂肪酸 (µg/mg)
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48小时
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粪便微生物种群
大体时间:48小时
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将从参与者那里收集粪便样本进行核酸提取、16S 等位基因 PCR 和测序,以测量微生物群落和标本概况
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48小时
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粪菊糖
大体时间:48小时
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将使用短酸水解和高效液相色谱法测量粪便菊糖含量
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48小时
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粪便总胆汁酸
大体时间:48小时
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将在 2 天内收集粪便样本,通过高效液相色谱-质谱法测量粪便胆汁酸(μmol/48 小时)。
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48小时
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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初级粪便胆汁酸百分比
大体时间:48小时
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粪便样本将在 2 天内收集,用于通过高效液相色谱-质谱法测量粪便胆汁酸 (µmol/48h)。
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48小时
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大便特征
大体时间:4天
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粪便特征将使用 4 天的排便日记进行测量
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4天
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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24小时饮食(食物摄入量)回忆
大体时间:6天
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24 小时饮食摄入量将使用国家癌症研究所开发的基于网络的自动自我管理饮食评估工具 (https://epi.grants.cancer.gov/asa24/) 提交。
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6天
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合作者和调查者
出版物和有用的链接
一般刊物
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