The goal of this study is to investigate comparisons between the intestinal microbiome in patients with obesity and in patients with obesity and Non-Alcoholic Fatty Liver Disease (NAFLD). With this protocol we hope to better understand how the microbiome of each individual works with disease progression.
The goal of this study is to investigate and compare the composition of the intestinal microbiome in patients with obesity only to patients with obesity and Non-Alcoholic Fatty Liver Disease (NAFLD). In addition, we will investigate the relationship between alterations in the intestinal microbiome, immune activation, and the progression of NAFLD to Non-Alcoholic Steatohepatitis (NASH). We hypothesize that alterations in the intestinal microbiome are associated with increased immune activation and progression of obesity associated NAFLD. Based on this hypothesis we propose the following aims: Aim 1. Identify and enroll pediatric cohort with obesity or obesity/NAFLD to study the role of the intestinal microbiome on the development of NAFLD. 1. Enroll participants through the NEW Kids program for treatment of pediatric obesity at Children's Hospital of Wisconsin (CHW). Identify and classify participants through initial clinical evaluation, collect clinical metadata, and obtain and process blood and stool samples for analysis. Demonstrate feasibility by showing that participants can be recruited and participate in the specific study protocol. 2. Follow study population through nutritional/exercise intervention, with follow up collection of clinical data, stool, and blood samples. Aim 2. Characterize the intestinal microbiome through quantitative PCR and high throughput sequencing analysis of stool specimens in participants with obesity and obesity/NAFLD. 1. Demonstrate feasibility by showing that sampling aliquots from patient fecal samples can be successfully analyzed by proposed methods and yield consistent results for duplicate samples. 2. Compare sequencing results and metagenomic analysis for study groups with particular attention to bacterial composition and metabolic capacity associated with energy harvest, lipid and carbohydrate transport, enhancement of epithelial barrier integrity, and choline metabolism. 3. Investigate whether intervention (nutritional/exercise) results in longitudinal alterations in the intestinal microbiome. Aim 3. Characterize evidence of systemic inflammation by C-reactive protein (CRP), Tumor necrosis factor alpha (TNF-alpha)Transforming growth factor beta 1 (TGF-beta and LPS Binding Protein (LBP) levels, and analyze results in relationship to the intestinal microbiome and the presence of NAFLD. 1. Compare levels of systemic inflammatory markers of participants with obesity vs. obesity/NAFLD 2. Investigate whether intervention (nutritional/exercise) results in longitudinal alterations in systemic inflammation.
Study Type
OBSERVATIONAL
2 tablespoons of blood will be drawn from participants at study entry, 3 months after study entry, and 6 months after study entry.
Stool will be collected from participants 3 times during the study -- at study entry, 3 months from study entry, and 6 months after study entry.
Body composition will be measured using a BodPod at study entry, 3 months after study entry, and 6 months after study entry.
Children's Hospital of Wisconsin
Milwaukee, Wisconsin, United States
Alterations in the intestinal microbiome are associated with increased immune activation and progression of obesity associated NAFLD.
Time frame: 3 years
Characterize the intestinal microbiome through quantitative analysis of stool samples in participants with obesity and those with obesity and NAFLD.
Time frame: 3 years
Characterize inflammatory markers of participants with obesity versus those obese participants that also have NAFLD.
Time frame: 3 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
A liver ultrasound will be performed at study entry and 6 months after study entry.