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Trial registered on ANZCTR
Registration number
ACTRN12618000024246
Ethics application status
Approved
Date submitted
22/12/2017
Date registered
12/01/2018
Date last updated
12/01/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Total body protein and sarcopenia in patients with liver cirrhosis
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Scientific title
Relationship between total body protein and cross-sectional skeletal muscle area in liver cirrhosis
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Secondary ID [1]
293669
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None
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Universal Trial Number (UTN)
U1111-1206-9534
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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:
cirrhosis
305960
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malnutrition
305961
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sarcopenia
305962
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Condition category
Condition code
Oral and Gastrointestinal
305158
305158
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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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Diet and Nutrition
305263
305263
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0
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Other diet and nutrition disorders
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Musculoskeletal
305264
305264
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Observational
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Patient registry
False
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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
All participants retrospectively identified will have undergone in vitro neutron activation analysis (IVNAA) and dual energy x-ray absorptiometry (DXA) measurements of total body protein as part of previous body composition research studies. Clinical medical records will be evaluated to identify individuals who have undergone routine clinical abdominal computed tomography (CT) and/or magnetic resonance imaging (MRI) scans within 30 days of IVNAA measurement.
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Intervention code [1]
299928
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Not applicable
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Comparator / control treatment
No control group.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
304307
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The primary outcome for this study is the relationship between total body protein (gold-standard measurements by IVNAA), and cross-sectional skeletal muscle area as identified from abdominal imaging (CT and/or MRI scan).
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Assessment method [1]
304307
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Timepoint [1]
304307
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Cross sectional abdominal imaging (CT or MRI) performed within 30 days of IVNAA measurement.
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Secondary outcome [1]
341550
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To determine the effect of hydration status (determined by total body water, derived from IVNAA and DXA measurements), on the relationship between total body protein (assessed by IVNAA) and cross-sectional skeletal muscle area (assessed from CT/MRI abdominal imaging).
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Assessment method [1]
341550
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Timepoint [1]
341550
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Cross sectional abdominal imaging (CT or MRI) performed within 30 days of IVNAA measurement.
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Eligibility
Key inclusion criteria
1. Patients with a clinical diagnosis of chronic liver disease/cirrhosis who have previously been participants in body composition studies conducted by the Body Composition Unit at Auckland University.
2. Undergone total body protein measurements by IVNAA as part of these prior research studies.
3. Undergone CT/MRI abdominal imaging for routine clinical reasons within 30 days of IVNAA.
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Minimum age
18
Years
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Maximum age
No limit
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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
1. Patients with acute hospital admissions, surgical procedures (including abdominal paracentesis), or other significant clinical events (major bleeding, encephalopathy, or sepsis) during the interval between IVNAA and abdominal imaging
2. Patients with cross-sectional imaging not including the third lumbar vertebral body.
3. Data obtained following liver transplantation.
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Retrospective
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Statistical methods / analysis
No sample-size calculations will be performed.
Linear regression using Pearson's correlation coefficient will be performed to examine the bivariate association between total body protein and skeletal muscle area. Sensitivity and specificity for previously-published cross-sectional muscle area cutoffs will be calculated for their association with total body protein depletion. Analysis of covariance (ANCOVA) will be used to adjust the means for TBP for comparison of SMA between normally hydrated and over-hydrated groups. To further assess the impact of over-hydration on SMA, a multiple linear regression model will be constructed using TBP and hydration index as independent variables, and SMA as the dependent variable.
Bland-Altman plots will be constructed for patients with both CT and MRI measurements of cross-sectional muscle area within a 30-day interval to assess agreement between these two modalities.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
7/03/2016
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Date of last participant enrolment
Anticipated
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Actual
6/03/2017
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Date of last data collection
Anticipated
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Actual
6/03/2017
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Sample size
Target
100
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Accrual to date
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Final
107
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Recruitment outside Australia
Country [1]
9461
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New Zealand
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State/province [1]
9461
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Auckland
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Funding & Sponsors
Funding source category [1]
298289
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Charities/Societies/Foundations
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Name [1]
298289
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Maurice and Phyllis Paykel Trust
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Address [1]
298289
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89 Grafton Road
Auckland 1148
New Zealand
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Country [1]
298289
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New Zealand
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Primary sponsor type
University
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Name
University of Auckland
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Address
Department of Surgery
Auckland City Hospital Support Building
2 Park Road
Grafton
Auckland 1023
New Zealand
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Country
New Zealand
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Secondary sponsor category [1]
297404
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None
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Name [1]
297404
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Address [1]
297404
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Country [1]
297404
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299288
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University of Auckland Human Participants Ethics Committee
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Ethics committee address [1]
299288
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The University of Auckland Private Bag 92019 Auckland 1142, New Zealand
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Ethics committee country [1]
299288
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New Zealand
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Date submitted for ethics approval [1]
299288
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22/06/2015
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Approval date [1]
299288
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10/08/2015
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Ethics approval number [1]
299288
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UAHPEC 015477
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Summary
Brief summary
Protein calorie malnutrition is common in patients with chronic liver disease/cirrhosis. Sarcopenia (reduced muscle mass) has been shown to be an independent predictor of mortality and morbidity in a wide range of conditions, including on the liver transplant waiting list, and also following transplantation. The cross-sectional area skeletal muscle on CT or MRI is a simple and widely available measurement that has previously been used as a measure of sarcopenia. However, it has not been validated against the gold standard method of TBP measured using in vivo neutron activation analysis (IVNAA). This study will compare two different ways of measuring body protein stores; cross sectional skeletal muscle area on CT or MRI will be compared to the gold standard method of in-vivo neutron activation analysis (IVNAA). Patients undergoing major abdominal surgery and chronic liver disease patients, who have previously been participants in studies conducted by the Body Composition Unit will be assessed for inclusion in the study. Individuals who have had both cross sectional imaging with CT or MRI and IVNAA within one month of each other will be identified retrospectively from laboratory and radiology records. No new measurement or prospective recruitment will be undertaken. We aim to validate the use of cross sectional skeletal muscle area as a measure of TBP in patients with chronic liver diease. This is relevant to future clinical and research studies that rely in this cross sectional imaging to measure sarcopenia in these patient populations.
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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
79922
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A/Prof Lindsay Plank
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Address
79922
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Department of Surgery
University of Auckland,
Private Bag 92019,
Auckland 1142,
New Zealand
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Country
79922
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New Zealand
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Phone
79922
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+64-9-923-6949
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Fax
79922
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Email
79922
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[email protected]
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Contact person for public queries
Name
79923
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Lindsay Plank
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Address
79923
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Department of Surgery
University of Auckland,
Private Bag 92019,
Auckland 1142,
New Zealand
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Country
79923
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New Zealand
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Phone
79923
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+64-9-923-6949
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Fax
79923
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Email
79923
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[email protected]
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Contact person for scientific queries
Name
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Lindsay Plank
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Address
79924
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Department of Surgery
University of Auckland,
Private Bag 92019,
Auckland 1142,
New Zealand
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Country
79924
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New Zealand
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Phone
79924
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+64-9-923-6949
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Fax
79924
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Email
79924
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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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