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Obesity, ChildhoodNCT03490448

The Changes of Body Composition, Glucolipid Metabolism and Bone Metabolism in Obese Children After Weight Loss

A study of Obesity, Childhood and Vitamin D Deficiency, run by Xinhua Hospital, Shanghai Jiao Tong University School of Medicine at 1 site in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Vitamin D plays a significant role in calcium and phosphorus homeostasis for maintaining structural integrity and function of musculoskeletal system. Furthermore, recent studies have revealed that vitamin D can decrease the risk of many conditions other than skeletal disease, including autoimmune diseases, cancers… Read more about this study

Who is it for?
Ages 9 to 17 years
Conditions the study is for
Obesity, Childhood, Vitamin D Deficiency
Could I receive a placebo?
No, everyone receives an active treatment
How many people
53 participants
Where
1 siteChina
Study dates
6 Jul 2014to 16 Aug 2014
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 9 to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Obesity was defined as having a body mass index (BMI) greater than or equal to the 95th percentile for age and sex according to WHO standard. BMI was calculated as weight (kg) divided by height squared (m2).

Who cannot join

  • 1) obesity caused by endocrine or heredity diseases (eg, hypothyroidism, Prader-Willi syndrome, single-gene defects);
  • 2) any disease influencing vitamin D metabolism (eg, such as metabolic bone diseases, rickets, nephritic syndrome and hepatic failure);
  • 3) any supplementation use or any medication affecting vitamin D metabolism use.

Trial locations and contacts

1 site in 1 country.

China1 site
  • Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine

    Shanghai, Shanghai Municipality, 200092

Other trials in China

About this study

Official title: The Changes of Body Composition, Glucolipid Metabolism and Bone Metabolism in Obese Children and Adolescents After Weight Loss Camp

Vitamin D plays a significant role in calcium and phosphorus homeostasis for maintaining structural integrity and function of musculoskeletal system. Furthermore, recent studies have revealed that vitamin D can decrease the risk of many conditions other than skeletal disease, including autoimmune diseases, cancers, obesity and obesity-related diseases, such as type 2 diabetes and cardiovascular disease. Vitamin D may influence calcium absorption to affect obesity indirectly, regulate adipocyte differentiation and relieve the development of metabolic syndrome by mediating levels of inflammatory factors.

Another indicator of bone metabolism-osteocalcin may also be involved in energy metabolism and glucose metabolism, and undercarboxylated osteocalcin (ucOC) is the form which has physiological activity. ucOC may recombine with the receptors on the surface of pancreas β cells, adipocytes, hepatocytes and intestinal endocrine cell to regulate insulin secretion and insulin sensitivity.

Read more

Currently, the prevalence of vitamin D deficiency is a global problem in all age groups currently, even in countries with sun exposure all year around. The obesity group tend to have a higher incidence of vitamin D deficiency.Moreover, the obesity group tend to have a higher incidence of vitamin D deficiency and a lower level of serum osteocalcin.

This study observed the changes of body composition and glucolipid metabolism and bone metabolism during weight loss, and investigated the correlations among them.

Read the detailed description

Obese children have a higher incidence of vitamin D deficiency (VDD), which resulted from unhealthy life style such as less time outdoors, more sedentary time, imbalance of dietary intake. Adipose tissue is the storage position of vitamin D, and the storage formation include 25-OHD2 and 25-OHD3. Theoretically, the reserves of vitamin D in adipose tissue of obese children might release to the circulation after weight loss. For further, it is necessary to clarify the relationship between the improvement of metabolic risk with vitamin D status after weight loss.

Osteocalcin is produced and secreted by osteoblast specifically. Recent studies have shown that it regulated glucose metabolism and energy metabolism. Obese group may have a lower level of serum osteocalcin. Both 25-OHD and osteocalcin have association with energy metabolism. This study will provide evidence to realize the relationship between bone metabolism and obesity.

In our study, all subjects were recruited from the obese children and adolescents aged 9~17 years who participated in six-week weight loss camp in July ~ August, 2014. Body mass index (BMI) was calculated as weight (kg) divided by height squared (m2). Obesity was defined as having a BMI greater than or equal to the 95th percentile for age and sex according to WHO standard. Exclusion criteria included: 1) obesity caused by endocrine or heredity diseases (eg, hypothyroidism, Prader-Willi syndrome, single-gene defects); 2) any disease influencing vitamin D metabolism (eg, such as metabolic bone diseases, rickets, nephritic syndrome and hepatic failure); 3) any supplementation use or any medication affecting vitamin D metabolism use.

All subjects underwent a closed-off weight loss program for six weeks. The intervention methods included aerobic exercise and appropriate caloric control. The dietary was designed on the basis of ensuring the daily energy physiological requirement, and basal metabolic rate (BMR) was calculated to formulate diet project according to Harris-Benedict formula. The diet was composed of 20% protein, 30% fat and 50% carbohydrates. During the camp, all subjects had never taken any kinds of nutritional supplements.

Before intervention, all subjects received exercise load test to ensure safe and effective physical exercise. In the exercise, heart rate was monitored to ensure the small-medial load aerobic exercise. The exercise programs included ball games, such as badminton, table tennis, and basketball, and also included jogging, brisk walking, swimming and cycle ergometer. All kinds of sports were conducted indoor, twice per day, 6 days per week, and lasted for 2 hours every time. The weight loss camp was staffed by professional sports coaches and medical workers. Exercise intensity was estimated by a formula: exercise intensity (target heart rate) =resting heart rate + heart rate reserve (maximum heart rate-resting heart rate) × (20%~40%).

Before and after intervention, fasting blood samples were collected and sent to Shanghai Adicon Central Lab Test Menu immediately stored in 4°C ice packs. The indicators of glucolipid metabolism and bone metabolism were tested. Total cholesterol (TC) with cholesterol oxidase, triglyceride (TG) with enzyme method (GPO-POD), high density lipoprotein (HDL) and low density lipoprotein (LDL) with homogeneous methods, fasting blood glucose (FBG) with hexokinase (HK) method, fasting insulin (FINS) with chemiluminescence method. Among the indicators of bone metabolism, osteocalcin, parathyroid hormone (PTH) and 25-OHD were assayed by electrochemiluminescence immunoassay, while bone specific alkaline phosphatase (BALP), total propeptide of type I procollagen (T-PINP) and β-isomerized form carboxy-terminal telopeptide of type I collagen (β-CTX) were determined by immunoenzymatic methods.

After blood samples were collected, anthropometric parameters were measured, including height (Seca 264, Germany), weight (Biospace 370, South Korea), triceps skinfold thickness (TST) and subscapular skinfold thickness (SST) (skinfold caliper 689900). For error reduction, every anthropometric measurement was conducted by the same trained personnels before and after weight-loss.

Being tested
aerobic exercise and appropriate caloric control
Keywords
vitamin D, obesity, body composition, glucose metabolism, lipid metabolism
Medical subject headings
Pediatric Obesity, Vitamin D Deficiency, Obesity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • aerobic exercise and appropriate caloric controlBehavioural

    The dietary was designed on the basis of ensuring the daily energy physiological requirement, and basal metabolic rate (BMR) was calculated to formulate diet project according to Harris-Benedict formula. The diet was composed of 20% protein, 30% fat and 50% carbohydrates.In the exercise, heart rate was monitored to ensure the small-medial load aerobic exercise. All kinds of sports were conducted indoor, twice per day, 6 days per week, and lasted for 2 hours every time.

Study groups in NCT03490448
Study groupRoleWhat they receive
intervention groupOtheraerobic exercise and appropriate caloric control
Receives: Behavioral: aerobic exercise and appropriate caloric control

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. changes of serum 25-OHD after weight loss

    Measured: after six-week weight loss camp

Secondary outcomes (3)
  1. changes of serum osteocalcin after weight loss

    Measured: after six-week weight loss camp

  2. changes of body composition after weight loss

    Indicators of body composition included weight, body mass index, triceps skinfold thickness and subcutaneous skinfold thickness.

    Measured: after six-week weight loss camp

  3. changes of glucolipid metabolism after weight loss

    Indicators of glucose metabolism included fasting blood glucose (FBG) and fasting insulin (FINS). Indicators of lipid metabolism included Total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL).

    Measured: after six-week weight loss camp

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Apr 2018
  2. Study start6 Jul 2014
  3. Primary completion16 Aug 2014
  4. Study completion16 Aug 2014

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
53 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03490448
Sponsor's protocol ID
XH-DCN-Obesity
Status last verified
Mar 2018
First submitted
22 Mar 2018
Last updated
6 Apr 2018
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Awad AB, Alappat L, Valerio M. Vitamin d and metabolic syndrome risk factors: evidence and mechanisms. Crit Rev Food Sci Nutr. 2012;52(2):103-12. doi: 10.1080/10408391003785458.

    PubMed 22059957
  • Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM; Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Jul;96(7):1911-30. doi: 10.1210/jc.2011-0385. Epub 2011 Jun 6.

    PubMed 21646368
  • Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr. 2004 Mar;79(3):362-71. doi: 10.1093/ajcn/79.3.362.

    PubMed 14985208
  • Lee NK, Sowa H, Hinoi E, Ferron M, Ahn JD, Confavreux C, Dacquin R, Mee PJ, McKee MD, Jung DY, Zhang Z, Kim JK, Mauvais-Jarvis F, Ducy P, Karsenty G. Endocrine regulation of energy metabolism by the skeleton. Cell. 2007 Aug 10;130(3):456-69. doi: 10.1016/j.cell.2007.05.047.

    PubMed 17693256
  • Ferron M, Hinoi E, Karsenty G, Ducy P. Osteocalcin differentially regulates beta cell and adipocyte gene expression and affects the development of metabolic diseases in wild-type mice. Proc Natl Acad Sci U S A. 2008 Apr 1;105(13):5266-70. doi: 10.1073/pnas.0711119105. Epub 2008 Mar 24.

    PubMed 18362359
  • Liu JJ, Chen YY, Mo ZN, Tian GX, Tan AH, Gao Y, Yang XB, Zhang HY, Li ZX. Relationship between serum osteocalcin levels and non-alcoholic fatty liver disease in adult males, South China. Int J Mol Sci. 2013 Sep 30;14(10):19782-91. doi: 10.3390/ijms141019782.

    PubMed 24084725
  • Palacios C, Gonzalez L. Is vitamin D deficiency a major global public health problem? J Steroid Biochem Mol Biol. 2014 Oct;144 Pt A:138-45. doi: 10.1016/j.jsbmb.2013.11.003. Epub 2013 Nov 12.

    PubMed 24239505
  • Nam GE, Kim DH, Cho KH, Park YG, Han KD, Kim SM, Lee SH, Ko BJ, Kim MJ. 25-Hydroxyvitamin D insufficiency is associated with cardiometabolic risk in Korean adolescents: the 2008-2009 Korea National Health and Nutrition Examination Survey (KNHANES). Public Health Nutr. 2014 Jan;17(1):186-94. doi: 10.1017/S1368980012004855. Epub 2012 Nov 20.

    PubMed 23168294
  • Torun E, Gonullu E, Ozgen IT, Cindemir E, Oktem F. Vitamin d deficiency and insufficiency in obese children and adolescents and its relationship with insulin resistance. Int J Endocrinol. 2013;2013:631845. doi: 10.1155/2013/631845. Epub 2013 Mar 27.

    PubMed 23606841
  • Wang JW, Tang QY, Ruan HJ, Cai W. Relation between serum osteocalcin levels and body composition in obese children. J Pediatr Gastroenterol Nutr. 2014 Jun;58(6):729-32. doi: 10.1097/MPG.0000000000000243.

    PubMed 24253362
  • Niu Y, Zhao XL, Ruan HJ, Mao XM, Tang QY. Uric acid is associated with adiposity factors, especially with fat mass reduction during weight loss in obese children and adolescents. Nutr Metab (Lond). 2020 Sep 22;17:79. doi: 10.1186/s12986-020-00500-9. eCollection 2020.

    PubMed 32983243

Questions about this trial

What is this clinical trial studying?

A study of Obesity, Childhood and Vitamin D Deficiency, run by Xinhua Hospital, Shanghai Jiao Tong University School of Medicine at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 6 Apr 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

changes of serum 25-OHD after weight loss (time frame: after six-week weight loss camp). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03490448, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Apr 2018.

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