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Adaptation of Human Gut Microbiota to Energetic Restriction (microbaria)

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ClinicalTrials.gov Identifier: NCT01454232
Recruitment Status : Completed
First Posted : October 18, 2011
Last Update Posted : March 15, 2019
Sponsor:
Information provided by (Responsible Party):
Assistance Publique - Hôpitaux de Paris

Study Description
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Brief Summary:

Gut microbiota ecology is altered in obesity and could link obesity and its complications. Bariatric surgery enables a major and sustained weight loss therefore improving obesity related disease.

the investigators primary aim is to evaluate gut microbiota adaptation to weight loss and the specific role of energetic restriction. Furthermore we aim to compare gut flora of obese patients post bariatric surgery to that of lean healthy volunteers.

Thus, the investigators plan to compare gut microbiota from 140 obese individuals before and after either restrictive (gastric banding) procedures or gastric bypass procedures to that of 40 lean healthy volunteers at baseline.


Condition or disease Intervention/treatment Phase
Obesity Metabolic Diseases Nutrition Disorders Body Weight Other: stools sampling Other: adipose tissue biopsy Not Applicable

Detailed Description:

The prevalence of obesity is rising to an epidemic level. Yet medical and pharmacological treatments have proven their limits. Dietetic modifications contribute to adipose tissue alterations and cross talk dysfunction with other tissues linked to weight maintenance. In a previous study in a model of abrupt weight loss 6 months after Roux-en-Y Bypass, the investigators observed a rapid adaptation of the dominant gut microbiota. Conversely some species were directly linked to the improvement of low grade inflammation independently of calory intake.

Therefore the investigators hypothesized that gut microbiota in obese patients could link food consumption with obesity alterations such as metabolic impairments, energetic storage dysfunction and increased systemic and adipose tissue inflammation.

The investigators want to address the specific role of energetic restriction in gut microbiota modification after weight loss.

To answer that question the investigators will evaluate gut microbiota composition before and during the first year after either gastric banding or gastric bypass surgery. they also aim to evaluate whether gut flora post surgery evolves toward that of lean healthy subjects Our study has several objectives. The investigators also aim to assess whether gut microbiota modification is associated with systemic and tissue inflammation reduction and metabolic improvement during the follow up.

This project is based on a clinical protocol performed in massively obese subjects (BMI>40 kg/m²). The investigators plan to recruit 70 obese patients addressed for gastric banding and 70 candidates for gastric bypass. Clinical phenotype, biochemical analysis, body composition, systemic and adipose tissue inflammation, endotoxemia and gut microbiota will be assessed at baseline and 1, 3 and 12 months after surgery. Specific food consumption will be recorded at every time point. A group of 40 lean healthy volunteers will undergo the same phenotyping.

Associations between all these clinical and biological parameters will be assessed at the different point of the follow up.

More generally, this project might lead us to elucidate a new function of gut microbiota and eventually consider novels anti obesity therapeutic strategies

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 140 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Other
Official Title: Modification of Human Gut Microbiota in Massive Obesity After Bariatric Surgery: the Role of Energetic Restriction
Actual Study Start Date : June 7, 2011
Actual Primary Completion Date : September 14, 2018
Actual Study Completion Date : September 14, 2018

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
gastric surgery
obese patients addressed for gastric surgery
 Other: stools sampling
stools sampling at baseline, 1, 3 and 12 months

Other: adipose tissue biopsy
surgical adipose tissue biopsy during surgery, 1, 3 and 12 months
Active Comparator: lean healthy subjects evaluated once
lean healthy subjects evaluated once
 Other: stools sampling
stools sampling at baseline, 1, 3 and 12 months

Other: adipose tissue biopsy
surgical adipose tissue biopsy during surgery, 1, 3 and 12 months


Outcome Measures
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Primary Outcome Measures :
  1. Analyse changes early, medium and long term changes in gut microbiota composition in a kinetic manner [ Time Frame: at 1, 3 and 12 months after surgery ]
  2. Compare gut microbiota kinetic changes in obese to gut microbiota healthy volunteers [ Time Frame: at 1, 3 and 12 months after surgery in the obese group and compare it to baseline in lean subjects ]

Secondary Outcome Measures :
  1. Establish early, medium and long term changes in insulin sensitivity and GLP1 secretion profile after oral glucose load and look for potential associations between these changes and gut microbiota composition [ Time Frame: 1, 3 and 12 months after surgery ]
  2. Establish early, medium and long term changes in systemic and adipose tissue inflammation and look for potential associations between gut microbiota composition and inflammation modification [ Time Frame: 1, 3 and 12 months after surgery ]
  3. Establish early, medium and long term changes in body composition and look for potential associations between these changes and gut microbiota modifications [ Time Frame: 1, 3 and 12 months after surgery ]
  4. Establish early, medium and long term changes in nutritional blood sample concentrations and look for a potential association between gut microbiota modifications. [ Time Frame: 1, 3, 12 months after surgery ]
  5. Establish early, medium and long term improvement in obesity related disease (reducing the number of treatments and the need for PPC use) and look for potential association with gut microbiota modification [ Time Frame: 1, 3 and 12 months after surgery ]

Eligibility Criteria
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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes
Criteria

Obese group

Inclusion criteria :

  • Obesity with BMI> 40 kg/m² or obesity with BMI between 35 and 40 kg/M² with comorbidities (OSA, type 2 diabetes, hypertension etc…)
  • Age: 18-65
  • women
  • weight stable for three months preceding surgery

Exclusion criteria :

  • Inflammatory disease
  • Pregnancy
  • Lactose intolerance
  • Antibiotherapy in the three months preceding surgery
  • cancer
  • Drugs (AINS)

Healthy group

Inclusion criteria :

  • 19<BMI<25kg/m²
  • Age: 18-65
  • women
  • non diabetic

Exclusion criteria :

  • Inflammatory disease
  • Pregnancy
  • Antibiotherapy in the two months preceding the visit
  • pregnancy
  • Drugs (AINS) in the 48h preceding the visit
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01454232


Locations
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France
Pitié Salpêtrière Hospital
Paris, France, 75013
Sponsors and Collaborators
Assistance Publique - Hôpitaux de Paris
Investigators
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Principal Investigator: Karine Clement, MD, PhD Assistance Publique - Hôpitaux de Paris
More Information
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Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: Assistance Publique - Hôpitaux de Paris
ClinicalTrials.gov Identifier: NCT01454232    
Other Study ID Numbers: P100111
First Posted: October 18, 2011    Key Record Dates
Last Update Posted: March 15, 2019
Last Verified: March 2019
Keywords provided by Assistance Publique - Hôpitaux de Paris:
Obesity
adipose tissue inflammation
Low grade systemic inflammation
gut microbiota
Bariatric surgery
Additional relevant MeSH terms:
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Obesity
Metabolic Diseases
Nutrition Disorders
 Body Weight
Overnutrition
Overweight