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Trial registered on ANZCTR
Registration number
ACTRN12610000049077
Ethics application status
Approved
Date submitted
3/12/2009
Date registered
18/01/2010
Date last updated
10/07/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
The Impact of Weight Loss on the Metabolic Syndrome
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Scientific title
In obese patients with the metabolic syndrome, we investigate outcomes with weight loss after bariatric surgery using the laparoscopic adjustable gastric band. This is a prospective cohort study monitoring resolution of the risk factors of metabolic syndrome including hypertension, dyslipidaemia and fasting glycaemia and therefore risk profile for cardiovascular disease and Type II diabetes.
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Secondary ID [1]
1297
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none
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Obesity
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Metabolic Syndrome
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Condition category
Condition code
Metabolic and Endocrine
252481
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0
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Metabolic disorders
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
This is a prospective cohort study observing the resolution of aspects of the metabolic syndrome with weight loss. Weight loss will be achieved by utilisation of a laparoscopically placed adjustable gastric band (LAGB) by a previously well described technique. Patients will be assessed preoperatively at the Centre for Bariatric Surgery (CBS), a dedicated bariatric surgery centre in Melbourne. They will have baseline blood tests reviewed and anthropometric measurements taken including weight, height, waist, neck and hip circumference. If they satisfy the criteria for the Metabolic syndrome as set out in the Adult treatment Panel III (ATP III) guidelines,they will be invited to take part in the study. Patients will be followed up at CBS by surgeons and physicians. They will be followed monthly for 9 months, and 3 monthly thereafter to a total of 24 months. Their progress will be reviewed, they will have adjustments to the band, and be given advice on achieving their weight loss goals. They will have their anthropometric parameters assessed by the same team of staff utilising the same instruments and methods. They will have blood tests performed at each visit.
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Intervention code [1]
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Not applicable
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Comparator / control treatment
uncontrolled
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Weight loss - Total and percent excess weight loss. Calibrated scales used at the same clinic for baseline and ongoing measurement of weight in kg.
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Assessment method [1]
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Timepoint [1]
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Baseline, 1, 2, 3, 4, 5, 6, 7, 8, 9, 12, 15, 18, 21, 24 months
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Primary outcome [2]
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Glycaemia/impaired fasting glucose/type II diabetes/ insulin resistance - Assessed by monthly bloods tests - fasting blood glucose,c-peptide,insulin levels, 3 monthly glycated haemoglobin (HbA1c), and calculated homeostasis model assessment of insulin resistance (HOMA IR).
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Assessment method [2]
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Timepoint [2]
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Baseline, 1, 2, 3, 4, 5, 6, 7, 8, 9, 12, 15, 18, 21, 24 months
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Primary outcome [3]
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Hypertension - utilising a sphygmomanometer -calibrated regularly. Antihypertensive medication use documented and changes in medication noted at each visit.
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Assessment method [3]
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Timepoint [3]
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Baseline, 1, 2, 3, 4, 5, 6, 7, 8, 9, 12, 15, 18, 21, 24 months
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Primary outcome [4]
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Dyslipidaemia - baseline and ongoing lipid profile from blood analysis - Cholesterol, Triglycerides, High density lipoprotein (HDL)-Cholesterol, Low density lipoprotein (LDL)-Cholesterol, LDLC/HDLC, Chol/HDLC
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Assessment method [4]
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Timepoint [4]
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Baseline, 1, 2, 3, 4, 5, 6, 7, 8, 9, 12, 15, 18, 21, 24 months
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Primary outcome [5]
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Waist circumference - using World Health Organisation (WHO) guidelines - trained clinic staff measuring at a line above the iliac crest, below the lowest rib - and directly around in a horizontal plane at end expiration.
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Assessment method [5]
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Timepoint [5]
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Baseline, 1, 2, 3, 4, 5, 6, 7, 8, 9, 12, 15, 18, 21, 24 months
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Primary outcome [6]
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Change in gastrointestinal hormones -Protein YY (PYY), Glucagon like peptide 1 (GLP-1), Grehlin, total pancreatic polypeptide (PP) - blood analysis in collaborator's laboratory in the United Kingdom.
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Assessment method [6]
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Timepoint [6]
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Baseline, 12 months, 24 months
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Primary outcome [7]
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Adipose tissue inflammation - macrophage recruitment in subcutaneous and visceral fat depots - Using histology and immunohistochenstry - adipose tissue will be analysed at the Walter and Eliza Hall Institute in Melbourne.
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Assessment method [7]
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Timepoint [7]
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baseline
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Primary outcome [8]
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Hepatic steatosis, and non-alcoholic steatohepatitis via core biopsy
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Assessment method [8]
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Timepoint [8]
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Baseline
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Secondary outcome [1]
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Quality of Life - SF-36 questionaire
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Assessment method [1]
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Timepoint [1]
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baseline 12, 24 months
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Eligibility
Key inclusion criteria
Obese patients Body Mass Index > 30
3 or more of Adult Treatment Panel III (ATPIII) criteria
Waist circumference >102 for men > 88cm for women.
Blood pressure >130/85 or being treated for hypertension.
Serum triglycerides >1.7mmol/L.
High Density Lipoprotein (HDL) cholesterol < 1.0 for men, < 1.3 for women.
Serum fasting glucose >5.6mmol/L
Fit For surgery
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Unfit for surgery.
Type I diabetes.
Unable to consent to trial.
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
22/05/2009
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
200
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Monash University
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Address [1]
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Centre for Obesity Research and Education
3rd Floor, Monash Medical School,
The Alfred Hospital,
Prahran, VIC, 3004
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Country [1]
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Australia
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Funding source category [2]
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Commercial sector/Industry
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Name [2]
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Allergan - unrestricted research grant
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Address [2]
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Level 4
810 Pacific Highway
Gordon, NSW 2072
Australia
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Country [2]
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Australia
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Funding source category [3]
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Other
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Name [3]
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Royal Australasian College of Surgeons - Foundation for Surgery Research Scolarship
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Address [3]
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Royal Australasian College of Surgeons
College of Surgeons' Gardens
250 - 290 Spring Street
East Melbourne VIC 3002
Australia
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Country [3]
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Australia
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Primary sponsor type
University
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Name
Monash University - Centre for Obesity Research and Education
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Address
CORE, Level 3 Monash Medical School,
Alfred Hospital
Commercial Road,
Prahran VIC 3004
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Other collaborator category [1]
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Individual
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Name [1]
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Dr John Wentworth
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Address [1]
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Clinical Researcher
The Walter and Eliza Hall Institute of Medical Research
1G Royal Parade
Parkville, 3050, VIC
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Country [1]
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Australia
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Other collaborator category [2]
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Individual
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Name [2]
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Dr Carel Le Roux
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Address [2]
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Metabolic Physician
Imperial College London,
South Kensington Campus,
London SW7 2AZ
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Country [2]
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United Kingdom
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Other collaborator category [3]
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Individual
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Name [3]
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Dr Ken Sikaris
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Address [3]
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Director of Chemical Pathology. Melbourne Pathology, 103 Victoria Parade,Collingwood, Vic, 3066
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Country [3]
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Australia
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Other collaborator category [4]
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Individual
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Name [4]
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A/Prof Michael Bailey
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Address [4]
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Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, Monash University, 3rd floor of the Burnet Building, Alfred Hospital, Commercial Road, Prahran, VIC 3004
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Country [4]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Monash University Standing Committee on Ethics in Research Involving Humans (SCERH)
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Ethics committee address [1]
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Building 3E, Room 111, Clayton Campus, Wellington Road, Clayton, VIC, 3800
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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13/01/2009
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Ethics approval number [1]
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2009000038
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Ethics committee name [2]
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The Avenue Hospital Human Research Ethics Committee (HREC)
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Ethics committee address [2]
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The Avenue Hospital HREC The Avenue Hospital 40 The Avenue WINDSOR VIC 3181
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
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Approval date [2]
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04/05/2009
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Ethics approval number [2]
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099
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Summary
Brief summary
The rates of overweight and obesity are increasing in large numbers in many countries over the past 2 decades. Along with that, we are seeing increasing numbers of people with related health problems including high blood pressure, problems with cholesterol, and elevated blood sugar levels. These factors are a constellation which together are called the metabolic syndrome, and which give people a higher risk of developing diabetes and cardiovascular disease in the future. We wish to study people with metabolic syndrome to discover how these problems resolve with different degrees of weight loss. We also seek to understand better the relationship between gut hormones, obesity, inflammation within fatty tissue and the hormones and proteins fat cells secrete, and their effect on the factors of the metabolic syndrome.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Lisa Doyle
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Address
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Centre for Obesity Research and Education
3rd Floor, Monash Medical School,
The Alfred Hospital,
Prahran, VIC, 3004
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Country
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Australia
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Phone
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61 3 9903 0721
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Fax
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61 3 9903 0171
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Lisa Doyle
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Address
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Centre for Obesity Research and Education
3rd Floor, Monash Medical School,
The Alfred Hospital,
Prahran, VIC, 3004
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Country
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Australia
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Phone
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61 3 9903 0721
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Fax
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61 3 9903 0171
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Effects of Bariatric Surgery on Liver Function Tests in Patients with Nonalcoholic Fatty Liver Disease.
2017
https://dx.doi.org/10.1007/s11695-016-2482-8
Embase
Modified thresholds for fibrosis risk scores in nonalcoholic fatty liver disease are necessary in the obese.
2017
https://dx.doi.org/10.1007/s11695-016-2246-5
Embase
Weight loss after laparoscopic adjustable gastric band and resolution of the metabolic syndrome and its components.
2017
https://dx.doi.org/10.1038/ijo.2017.59
Embase
Detailed Description of Change in Serum Cholesterol Profile with Incremental Weight Loss After Restrictive Bariatric Surgery.
2018
https://dx.doi.org/10.1007/s11695-017-3015-9
N.B. These documents automatically identified may not have been verified by the study sponsor.
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