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Trial registered on ANZCTR
Registration number
ACTRN12612001087842
Ethics application status
Approved
Date submitted
10/10/2012
Date registered
10/10/2012
Date last updated
18/12/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
The independent effects of diet and exercise in the progression of chronic liver disease
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Scientific title
Distinct effects of diet and exercise on liver histology and cardiometabolic risk factors in non-alcoholic steatohepatitis
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Secondary ID [1]
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nil
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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:
Non-alcoholic fatty liver disease (NAFLD)
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Condition category
Condition code
Diet and Nutrition
287923
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0
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Obesity
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Oral and Gastrointestinal
287929
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A group based circuit exercise training program (EX) (without changes to dietary intake), supervised by an exercise physiologist, involving one hour of training three times per week for six months. The circuit training consists of 15 resistance exercises with training intensity fixed at 50% of one repetition maximum (1-RM), reassessed monthly. The 1-RM test involves the participant lifting the heaviest weight possible whereby they can perform only 1 repetition. This weight is then halved and set as the weight used for the training session. This assessment is individualised for each muscle group and repeated monthly so that any increases in strength (1-RM) during the program are accounted for and the intensity remains stable at 50% 1-RM relative to improving strength.
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Intervention code [1]
285837
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Lifestyle
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Comparator / control treatment
diet-induced (DI) energy restriction (without changes to physical activity) with the aim of 5-10% body weight loss over 4 months and maintenance of weight for a further two months. The Dietary group will be prescribed an individualised 500kCal/day energy deficit diet by an accredited practicing Dietitian for the first 2 months with an aim to decrease weight by 0.5kg per week. The dietary composition aims to provide 45% carbohydrate, 35% fat and 20% protein. Participants have weekly appointments with the Dietitian for the first 4 months, followed by fortnightly appointments for 2 months whereby energy prescription is adjusted to ensure maintenance of weight loss. Diet diaries and diet histories are taken to assess food intake.
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Control group
Active
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Outcomes
Primary outcome [1]
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Liver Histology: A liver biopsy will be performed at baseline and at 6 months to assess steatosis, lobular inflammation, hepatocyte ballooning and fibrosis. The histological features of disease will be used in a validated scoring system (NAFLD activity score). Change in individual features and scores will be monitored.
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Assessment method [1]
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Timepoint [1]
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6 months
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Secondary outcome [1]
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Hepatic and Peripheral Insulin resistance: Sites and severity of insulin resistance will be assessed using a euglycaemic hyperinsulinemic clamp technique with stable glucose tracer infusion to detect both liver and muscle insulin resistance. The clamp assessment requires infusion of insulin and labelled glucose and blood draws every 5-10 mins for 2 hours until steady state infusions are reached.
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Assessment method [1]
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Timepoint [1]
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6 months
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Eligibility
Key inclusion criteria
Biopsy proven Nonalcoholic fatty liver disease
BMI>25kg/m2
Non-diabetic
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Minimum age
18
Years
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Maximum age
70
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
Exclusion criteria included the presence of other liver diseases or evidence of cirrhosis, alcohol consumption > 40 g/day (males) or > 20 g/day (females), and diabetes
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
It is an open label study as concealment of intervention is not possible. Participants are recruited from hospital outpatient clinics.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Once consented, patients are randomised to either diet or exercise intervention by computer generated random number
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/06/2009
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Actual
1/06/2009
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Date of last participant enrolment
Anticipated
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Actual
30/06/2012
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Date of last data collection
Anticipated
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Actual
30/12/2012
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Sample size
Target
20
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Accrual to date
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Final
17
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Recruitment in Australia
Recruitment state(s)
QLD
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council
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Address [1]
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University of Queensland
Princess Alexandra Hospital
Ipswich Rd, Brisbane, Qld 4102
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Princess Alexandra Hospital
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Address
Ipswich Rd
Woolloongabba, Qld 4102
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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The University of Queensland
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Address [1]
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Diamantina Institute
Princess Alexandra Hospital
Ipswich Rd Woolloongabba Qld 4102
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Country [1]
284938
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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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Princess Alexandra Hospital
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Ethics committee address [1]
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Ipswich Rd Woolloongabba Qld 4102
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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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23/06/2006
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Ethics approval number [1]
288174
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PAH2006/046
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Summary
Brief summary
NAFLD is a common liver disease associated with obesity and insulin resistance. There is no drug therapy and while there is general consensus that lifestyle intervention is effective at reducing steatosis our understanding of the distinct roles of diet and exercise on liver injury remains unclear. This study assesses the histological and metabolic effects of 6 months circuit exercise training compared with diet-induced weight loss in overweight patients with NAFLD.
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Trial website
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Trial related presentations / publications
Hickman IJ, Byrne NM, Croci I, Chachay VS, Clouston AD, Hills AP, Bugianesi E, Whitehead JP, Gastaldelli A, O'Moore-Sullivan TM, Prins JB and Macdonald GA (2013) A Pilot Randomised Study of the Metabolic and Histological Effects of Exercise in Non-alcoholic Steatohepatitis. J Diabetes Metab 4: 300.doi:10.4172/2155-6156.1000300. Croci I, Byrne NM, Chachay VS, Hills AP, Clouston AD, O'Moore-Sullivan TM, Prins JB, Macdonald GA, Hickman IJ. Independent effects of diet and exercise training on fat oxidation in non-alcoholic fatty liver disease. World J Hepatol. 2016 Sep 28;8(27):1137-1148. Croci I, Borrani F, Byrne NM, Wood R, Hickman IJ, Cheneviere X, Malatesta D. Reproducibility of Fatmax and fat oxidation rates during exercise in recreationally trained males. PLoS One. 2014 Jun 2;9(6):e97930. doi: 10.1371/journal.pone.0097930. Ilaria Croci, Ingrid J Hickman, Rachel E Wood, Fabio Borrani, Graeme A Macdonald, Nuala M Byrne. Fat oxidation over a range of exercise intensities: fitness versus fatness. Appl Physiol Nutr Metab. 2014 Dec;39(12):1352-9. doi: 10.1139/apnm-2014-0144. Ipavec-Levasseur S, Croci I, Choquette S, Byrne NM, Cowin G, O'Moore-Sullivan TM, Prins JB, Hickman IJ. Effect of 1-h moderate-intensity aerobic exercise on intramyocellular lipids in obese men before and after a lifestyle intervention. Appl Physiol Nutr Metab. 2015 Aug 17:1-7
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Public notes
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Attachments [1]
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/AnzctrAttachments/363131-Hickman et al 2013.pdf
(Publication)
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Contacts
Principal investigator
Name
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Dr Ingrid Hickman
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Address
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Dept Nutrition and Dietetics, Princess Alexandra Hospital Ipswich Rd Woolloongabba Qld 4102
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Country
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Australia
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Phone
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+61 7 3176 5588
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Ingrid Hickman
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Address
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Dept Nutrition and Dietetics
Ground Floor Building 15
Princess Alexandra Hospital
Ipswich Rd Woolloongabba Qld 4102
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Country
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Australia
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Phone
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+61 7 3176 7132
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Fax
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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 Ingrid Hickman
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Address
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Dept Nutrition and Dietetics
Ground Floor Building 15
Princess Alexandra Hospital
Ipswich Rd Woolloongabba Qld 4102
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Country
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Australia
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Phone
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+61 7 3176 7132
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Fax
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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
No additional documents have been identified.
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