NCT04642482

Synbiotic Therapy on Intestinal Microbiota and Insulin Resistance in Obesity

The Effect of Synbiotic on Intestinal Microbiota and HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) on Obesity

• Status: Completed
• Phase: Phase 4
• Study type: Interventional
• Enrollment: 16 (actual)
• Sponsor: Hasanuddin University · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Accepted

Summary

Background : There is a plausible relationship between microbial gut and insulin resistance. Intervention to prevent insulin resistance by modifying the microbial gut has been proposed but limited studies demonstrates the expected impact. One of the possible way to manipulate the microbial gut is the administration of synbiotic (prebiotic and probiotic). Objective : This study aim to address the impact of synbiotic administration to the microbial gut and insulin resistance. Brief Methodology : A Quasi Experimental study with multiple arms is conducted to healthy participants. All subjects will undergo a microbial gut taxonomic analysis using faecal sample and blood examination to determine the insulin resistance status (using Homeostatic Model Assessment for Insulin Resistance/HOMA-IR approach). Synbiotic will be given to intervention arm and active comparator will use maltodextrin. Repeated measurement will be conducted after 8 weeks and 12 weeks from the day of administration. Hypothesis : A superiority trial hypothesis is applied, assuming that the synbiotic group will demonstrates higher variety of microbial gut and lower HOMA-IR level

Detailed description

Study Location : This study will recruit the healthy participants from the university Target Population: Healthy Participants General Study Design : Quasi Experimental study with a comparator Sample Size calculation : Difference between two means of HOMA IR from pilot data (7) and standard deviation 2.9, with 5% Type I error, and 80% Power yielded a total of 16 participants for two arms Management of Sample: 1. Faecal Sample handling 1. Patient should undergo 8 hours of fasting prior to faecal examination 2. DNA Extraction 3. Lysate preparation and centrifuge faecal sample 4. Mixing lysate with sample 5. Column wash 6. DNA elution 7. DNA storing 8. DNA sequencing and analysis 9. taxonomical analysis 2. Fasting blood glucose 1. Patient should undergo 8 hours of fasting prior to Fasting blood glucose 2. Blood is taken from cubital vein 3. Spectrometry is conducted based on the NADPH formation from the equation below D-glucose+ATP -----\> Glucose-6-phospate+ADP Glucose-6-phospate+NAD ---- G-6-PDH ---\> D-Gluconate-6 phospate+NADH+H 3. Insulin level 1. Centrifuge blood to obtain the serum 2. The monoclonal anti-insulin antibody is given to the serum 3. detection is based on the anti-insulin antibody and insulin complex formation 4. Homeostatic Model Assessment for Insulin Resistance/ HOMA-IR value is calculated from glucose level multiply by insulin level and divided by 405. Protection for adverse event 1. All subjects are given the consent regarding the potential harm of synbiotic administration 2. All subjects will follow the protocol of reporting the any adverse event (most likely, severe constipation) 3. All subjects will be treated accordingly and hospitalisation if needed. Statistical Analysis 1. General Analysis : Intention To Treat (ITT) 2. Propensity Score Matching will be conducted prior to intervention 3. A repeated measure ANOVA will be performed, whereas Generalized Linear Mixed Model treating the intervention as dummy variable will be performed if ANOVA assumptions can not be fulfilled.

Conditions

• Obesity
• Insulin Resistance

Interventions

Type	Name	Description
DIETARY_SUPPLEMENT	Synbiotic (Rillus)	Participants in this group will be given a fine powder of synbiotic formula and should be taken orally without diluted with water.
DRUG	Placebo	Participants in this group will be given a fine powder of maltodextrin formula and should be taken orally without diluted with water.

Timeline

• Start date: 2019-09-24
• Primary completion: 2019-12-26
• Completion: 2020-09-01
• First posted: 2020-11-24
• Last updated: 2020-11-24

Locations

1 site across 1 country: Indonesia