Effect of High-protein High-fiber Diet in Patients With Autoimmune Hepatitis
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Purpose
Autoimmune hepatitis is a chronic disease of the liver caused by an alteration of the immune response that attacks the body's own hepatocytes, progressively, leading to cirrhosis and liver failure.
There are few studies on dietary management in hepatitis and most of theme have focused on micronutrients specifically vitamin D to prevent osteoporosis, and decreased symptoms of other diseases associated, but few recommendations have been made regarding a complete dietary approach. Fiber has been proven to increase the excretion of nitrogen products and consequently reduce its blood levels and an adequate protein intake (1.2g/kg) has shown to decrease endogenous catabolism in cirrhotics patients.
The implementation of a high protein high fiber nutrition plan and improves nutritional status of patients with autoimmune cirrhosis.
| Condition | Intervention |
|---|---|
|
Autoimmune Hepatitis Cirrhosis |
Dietary Supplement: High protein high fiber diet |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Supportive Care |
| Official Title: | Effect of a High-protein High-fiber Diet and Nutritional Status, Serum Ammonia Concentration and Plasma Cytokines in Patients With Autoimmune Hepatitis |
- Nutritional Status [ Time Frame: Participants will be assessed for six months ] [ Designated as safety issue: No ]Measured with the following parameters:body weight and height (to calculate BMI), triceps skinfold and mid-arm circumference (to calculated mid-arm muscle circumference, fat mass, fat free mass total, intracellular and extracellular body water obtained by bioelectrical impedance analysis and individual vectors obtained by bioelectrical impedance vector analysis.
- Minimal hepatic encephalopathy [ Time Frame: Participants will be assessed for six months ] [ Designated as safety issue: No ]Assessed by psychometric Hepatic Encephalopathy (PHES) and Critical Flicker Frequency (CFF), at visit 0 months and 6 months visit.
- Quality of life [ Time Frame: Participants will be assessed for six months ] [ Designated as safety issue: No ]Assessed by CLDQ and SF-36 questionnaires, at visit 0 months and 6 months visit.
| Estimated Enrollment: | 40 |
| Study Start Date: | January 2012 |
| Estimated Study Completion Date: | July 2013 |
| Estimated Primary Completion Date: | July 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Autoimmune hepatitis (Non-cirrhotic)
A personalized high protein high fiber dietary plan will be provided to each participant from both groups. Each participant will receive nutritional counseling once a month during six months.
|
Dietary Supplement: High protein high fiber diet
A personalized high protein high fiber dietary plan will be provided to each participant from both groups. Each participant will receive nutritional counseling once a month during six months. Each participant will receive nutritional counseling once month during six months. |
|
Experimental: Autoimmune hepatitis (Cirrhotic)
A personalized high protein high fiber dietary plan will be provided to each participant from both groups. Each participant will receive nutritional counseling once a month during six months.
|
Dietary Supplement: High protein high fiber diet
A personalized high protein high fiber dietary plan will be provided to each participant from both groups. Each participant will receive nutritional counseling once a month during six months. Each participant will receive nutritional counseling once month during six months. |
Detailed Description:
Each participant will receive a high protein (1.2g/kg/day) and high fiber (30g/day) dietary plan. The monitoring of adherence to the diet will be once a month for the duration of the study period.
There will be an nutritional assessment by anthropometric techniques: arm circumference, triceps skinfold, weight, height and body mass index as parameters of malnutrition by taking the standard for cirrhotic patients. Body composition was measured by bioelectric impedance to obtain fat mass, lean and total fluid content.
The presence of minimal hepatic encephalopathy will be assessed by PHES and CFF and applied three times during the study and the quality of life questionnaire SF-36 CLDQ and will be held in direct interview at the first visit and at study end.
Were also measured serum concentrations of ammonium, TNF-alpha, IL-1, IL-6, IL-10, renin, angiotensin and aldosterone.
Eligibility| Ages Eligible for Study: | 20 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
Autoimmune hepatitis (Non cirrhotic)
- Diagnose of Autoimmune hepatitis
- Presence of antinuclear antibody (ANA, SMA)
- Biochemical evidence, based on elevation of transaminases
- Biopsy compatible with Autoimmune hepatitis
- Ambulatory patients
Autoimmune hepatitis (Cirrhotic)
- Presence of antinuclear antibody (ANA, SMA)
- Biochemical evidence, based on elevation of transaminases
- Biopsy compatible with autoimmune cirrhosis
- Hepatic cirrhosis by USD
- Ambulatory patients
- Diagnose of Autoimmune cirrhosis by two or more of the following criteria:
- Albumin <3.4g/dl
- INR>1.2
- Total bilirubin >2mg/dl
- Presence of esophageal varices by endoscopy
Exclusion Criteria:
- Hospitalized patients
- Overlapping syndrome with predominant primary biliary cirrhosis
- Chronic renal failure
- Hepatocellular carcinoma
- Neuropsychiatric disorders
Contacts and Locations| Contact: Aldo Torre Delgadillo, M.D. | 54870900 ext 2711 | detoal@yahoo.com |
| Mexico | |
| Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán | Recruiting |
| Mexico City, D.f., Mexico, 14000 | |
| Contact: Aldo Torre Delgadillo, M.D. M.Sci 54870900 ext 2711 detoal@yahoo.com | |
| Contact: Ariadna Karen Flores Balbuena, LN 54870900 ext 2711 nut.ariadnakaren@hotmail.com | |
| Principal Investigator: Aldo Torre Delgadillo, M.D. M.Sci | |
| Sub-Investigator: Ariadna Karen Flores Balbuena | |
| Principal Investigator: | Aldo Torre Delgadillo, M.D. M.Sc | INCMNSZ |
More Information
No publications provided
| Responsible Party: | ALDO TORRE DELGADILLO, Principal Investigator, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran |
| ClinicalTrials.gov Identifier: | NCT01655121 History of Changes |
| Other Study ID Numbers: | GAS-501-11/12-1 |
| Study First Received: | July 12, 2012 |
| Last Updated: | December 5, 2012 |
| Health Authority: | Mexico: Secretaria de Salud |
Additional relevant MeSH terms:
|
Hepatitis, Autoimmune Autoimmune Diseases Hepatitis Hepatitis A Liver Cirrhosis Fibrosis Liver Diseases Digestive System Diseases |
Hepatitis, Viral, Human Virus Diseases Enterovirus Infections Picornaviridae Infections RNA Virus Infections Pathologic Processes Hepatitis, Chronic Immune System Diseases |
ClinicalTrials.gov processed this record on May 16, 2013