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| Name | Class |
|---|---|
| Canadian Institutes of Health Research (CIHR) | OTHER_GOV |
| MOUNT SINAI HOSPITAL | OTHER |
| University of Toronto | OTHER |
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More and more people in Canada and around the world are severely (morbidly) obese, and this is associated with a high risk for poor blood sugar control (insulin resistance, IR) and diabetes. Weight loss is often very hard to achieve for morbidly obese patients. Bariatric surgery is a very effective treatment, but it has some risks and is not available to all patients. Therefore, alternative treatments are needed.
The gut bacteria (intestinal microbiome) might play a role for the development of obesity and IR. Several studies in animals have shown that transferring stool from lean mice or humans into obese animals could lead to weight loss and improve IR. One human study has confirmed this. The investigators are therefore examining, whether transfer of stool from healthy lean people into morbidly obese patients with IR will improve blood sugar control, weight, and other obesity related parameters. This will be done in a randomized controlled trial. Effects on mental health and the bacterial in the mouth related to gum disease will also be assessed.
If successful, fecal transfer could be a new alternative treatment approach for morbidly obese patients or those with IR who do not have access to or do not want to undergo bariatric surgery.
The coupled disorders of morbid obesity and type 2 diabetes (T2D) are a major and growing public health problem in Canada. The Public Health Agency of Canada 2011 report, Obesity in Canada, showed that 5.1% and 2.7% of Canadians had obesity class II (body mass index (BMI) 35.0-39.9) and III (BMI >40 kg/m2), respectively. Morbid obesity is associated with not only T2D (up to 42% of morbidly obese patients), but also cardiovascular complications, non-alcoholic fatty liver disease and sleep apnea, and the prevalence of psychiatric disorders, particularly depression and anxiety, is high in this population. As morbid obesity is very difficult to treat, drastic measures are required, and bariatric surgery is often the only viable treatment option. Bariatric surgery is nowadays a frequently performed procedure (about 400 surgeries/year at the University Health Network (UHN)), and there are different techniques, including gastric banding, sleeve gastrectomy, and Roux-en-Y gastric bypass. Of these procedures, the Roux-en-Y gastric bypass surgery has become the gold standard, and it is highly effective in inducing long-term weight loss and improving or even resolving all of the obesity associated comorbidities. However, bariatric surgery is invasive, costly, has a risk of complications, and requires life-long commitment to a restricted diet. Therefore, a significant proportion of patients with morbid obesity is not willing to undergo the procedure, and a small proportion is excluded from the procedure due to other physical or mental health problems.In addition, depending on the health care system, bariatric surgery might not be available to a large proportion of patients. Regarding the growing rates of obesity and morbid obesity world-wide, less expensive and less invasive alternatives to bariatric surgery are urgently needed.
Even though obesity largely results from an imbalance between energy intake and energy expenditure, it has been shown that several factors, including the genetic background can render individuals susceptible to obesity. Most recently, the role of the intestinal microbiome has been under investigation. It has been shown that obese people have an intestinal microbiome and metagenome that is significantly different from lean controls, and this is even true in identical twins discordant for obesity. In addition, patients with T2D have a different intestinal microbiome than controls. Work done in rodents showed that fecal microbiota transplant (FMT) from lean to obese animals (and vice versa) can affect fat mass and parameters of the metabolic syndrome. It is thus possible that FMT may benefit human obesity with related metabolic abnormalities. FMT is becoming standard therapy for patients with refractory Clostridium difficile colitis and may become a treatment option in other gastrointestinal disorders. Only one human study (n=9) investigated FMT from lean subjects to obese patients (~BMI 35 kg/m2) with metabolic syndrome and showed improvement in insulin sensitivity. Taken altogether, these very exciting results led us to hypothesize that that FMT from healthy lean donors could effectively induce metabolic improvement (i.e. insulin resistance (IR)) and weight loss) by distinct microbe-specific mediated mechanisms. The investigators will examine this in a single-center, double-blind, randomized controlled parallel-group trial (RCT).
Furthermore, emerging evidence shows that the intestinal microbiome, through the gut-brain axis, can influence mood disorders. First animal studies suggest that FMT can transfer depression and anxiety and therefore, FMT from healthy individuals may provide some benefits. Therefore, the investigators will also assess, whether FMT influences depression and anxiety, which are highly prevalent in obese patients. Finally, our Canadian Institutes for Health Research (CIHR) Team Grant, which supports this RCT, is also studying the potential relationship between obesity, T2D and the oral microbiome (OM). Considering that microbes present in the saliva are swallowed in significant numbers-about 10^12 oral bacteria per day-and that this may influence the composition of the intestinal microbiome, the investigators are also exploring the potential relationship between oral and intestinal microbiome and their associations with obesity and T2D. Having a FMT protocol gives us the unique opportunity to further assess this potential relationship and determine if FMT may change OM by improving obesity and metabolic parameters. This has not been previously studied in animals or humans.
The aims of this RCT are to assess whether FMT from healthy lean individuals into morbidly obese patients with IR who decline bariatric surgery, leads to 1) improvement in metabolic parameters: IR, BMI, and other obesity related parameters; 2) improvement in mood disorders: depression and anxiety scores; 3) changes in the intestinal microbiome and metabolome. 4) In addition, by assessing the OM through the FMT protocol and by combining these results with the results of our other protocols in a similar patient population going through bariatric surgery, the investigators will explore the relationship between oral/intestinal microbiome and obesity/metabolic parameters. 5) Furthermore, as planned in our CIHR Team Grant, the investigators will use the FMT from the lean donors and transfer into obese mice to assess the effect of FMT on mechanisms related to glucose metabolism. These additional experiments are not part of this protocol but are mentioned briefly, as stool samples and data from the patients and donors participating in the FMT trial will be used for the other studies in our CIHR Team Grant.
Significance. The number of obese patients is growing world-wide. The investigators are examining here a'medical bypass' solutions to treat the 40-50% of obese patients that meet the criteria set by the National Institutes for Health (NIH) for bariatric surgery (12, 36) but decline (13), or the much larger population of obese patients (BMI 30-40 kg/m2) who may not be considered for surgical treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Allogenic treatment group | Experimental | Fecal filtrate from 150 g stool from healthy lean donors |
|
| Autologous control group | Placebo Comparator | Fecal filtrate from 150 g of the recipient's own stool |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fecal filtrate from 150 g stool from healthy lean donors | Biological | 150 g stool from healthy lean donors will be diluted in 0.9% normal saline to a total volume of 450 mL. Preparation from frozen stool. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Insulin Resistance Compared to Baseline | Looking at the change in Homeostasis model of assessment for insulin resistance (HOMA-IR). HOMA-IR > 2.73 is considered as insulin resistance. The higher HOMA-IR, the worse the insulin resistance. For this measure, we looked at the change in HOMA-IR. Those with more reduction in HOMA-IR experience more improvement in their insulin resistance. | 1 month, 3 month |
| Measure | Description | Time Frame |
|---|---|---|
| Weight | Body weight (kg) | Baseline, 1 mo, 3 mo |
| Body Mass Index | Weight (kg)/ height (m^2) | Baseline, 1 mo, 3 mo |
| Measure | Description | Time Frame |
|---|---|---|
| Hemoglobin A1c | Blood measurement which measures proportion of glycated hemoglobin to total hemoglobin. This measurement assesses the blood glucose control in the last 3 months. Generally, hemoglobin A1c < 0.060 is normal, 0.060 ≤ hemoglobin A1c <0.065 is prediabetic and ≥ 0.065 is diabetic. | Baseline, 1 mo, 3 mo |
Inclusion Criteria:
Exclusion Criteria:
In the 3 months prior to study entry, regular intake of:
Type 1 or type 2 diabetes
chronic gastrointestinal diseases
previous gastrointestinal surgery modifying the anatomy
smoking
pregnancy or breastfeeding
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| Name | Affiliation | Role |
|---|---|---|
| Johane P Allard, MD | University Health Network, University of Toronto | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Health Network | Toronto | Ontario | M5G 2C4 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22728514 | Background | Vrieze A, Van Nood E, Holleman F, Salojarvi J, Kootte RS, Bartelsman JF, Dallinga-Thie GM, Ackermans MT, Serlie MJ, Oozeer R, Derrien M, Druesne A, Van Hylckama Vlieg JE, Bloks VW, Groen AK, Heilig HG, Zoetendal EG, Stroes ES, de Vos WM, Hoekstra JB, Nieuwdorp M. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome. Gastroenterology. 2012 Oct;143(4):913-6.e7. doi: 10.1053/j.gastro.2012.06.031. Epub 2012 Jun 20. | |
| 25982290 |
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The current data sharing plans for the current study are unknown and will be made available at a later date
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| ID | Title | Description |
|---|---|---|
| FG000 | Allogenic Treatment Group | Fecal filtrate from 150 g stool from healthy lean donors Fecal filtrate from 150 g stool from healthy lean donors: 150 g stool from healthy lean donors will be diluted in 0.9% normal saline to a total volume of 450 mL. Preparation from frozen stool. |
| FG001 | Autologous Control Group | Fecal filtrate from 150 g of the recipient's own stool Fecal filtrate from 150 g of the recipient's own stool: 150 g stool from the recipient will be diluted in 0.9% normal saline to a total volume of 450 mL. Preparation from frozen stool. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Allogenic Treatment Group | Fecal filtrate from 150 g stool from healthy lean donors Fecal filtrate from 150 g stool from healthy lean donors: 150 g stool from healthy lean donors will be diluted in 0.9% normal saline to a total volume of 450 mL. Preparation from frozen stool. |
| BG001 | Autologous Control Group |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in Insulin Resistance Compared to Baseline | Looking at the change in Homeostasis model of assessment for insulin resistance (HOMA-IR). HOMA-IR > 2.73 is considered as insulin resistance. The higher HOMA-IR, the worse the insulin resistance. For this measure, we looked at the change in HOMA-IR. Those with more reduction in HOMA-IR experience more improvement in their insulin resistance. | Posted | Median | Inter-Quartile Range | Index | 1 month, 3 month |
|
Adverse events were collected at 1month and 3months post-FMT.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Allogenic Treatment Group | Fecal filtrate from 150 g stool from healthy lean donors Fecal filtrate from 150 g stool from healthy lean donors: 150 g stool from healthy lean donors will be diluted in 0.9% normal saline to a total volume of 450 mL. Preparation from frozen stool. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Diarrhea | Gastrointestinal disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Scientific Associate | University Health Network | 416-340-5159 | kschweng@uhnresearch.ca |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | May 10, 2020 | Dec 12, 2022 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D009767 | Obesity, Morbid |
| D007333 | Insulin Resistance |
| D003863 | Depression |
| D001008 | Anxiety Disorders |
| ID | Term |
|---|---|
| D009765 | Obesity |
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
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|
| Fecal filtrate from 150 g of the recipient's own stool | Biological | 150 g stool from the recipient will be diluted in 0.9% normal saline to a total volume of 450 mL. Preparation from frozen stool. |
|
|
| Appetite Score | Appetite score according to visual analog scale. Scores range from 0 to 10. In hunger, zero means not hungry at all. In prospective consumption, 0 means "don't think they can eat anything at all" and lower score is better. In sweet craving, zero means "they very much would like to eat something sweet", thus, higher score is better. | Baseline, 1 mo, 3 mo |
| Quality of Life Questionnaire | RAND 36-Item Health Survey 1.0 (SF-36). It is a 36-item questionnaire that asks questions about physical functioning, bodily pain, emotional well-being, social functioning, energy/fatigue, and general health perceptions, role limitations due to physical health problems, role limitations due to personal or emotional problems. The lowest score is 0 and the highest score is 100. Higher score shows better overall quality of life. | Baseline, 3 mo |
| Depression Score | Montgomery-Åsberg Depression Rating Scale (MADRS) is used in assessing severity od depressive episode. The score for each question is combined for the total score which ranges from 0 to 60. Zero means no depressive episode and 60 means severe depression. | Baseline, 3 mo |
| Anxiety Score | Hamilton Anxiety Rating Scale (Ham-A) is a questionnaire that assesses anxiety. The scale is 0 to 30. 0 means no anxiety present and 30 means severe anxiety. | Baseline, 3 mo |
| Change in Intestinal Microbiome in Stool, Composition |
Measured by metagenomic sequencing. This measurement assesses the change in bacterial relative abundance level (in percentage) in the stool following the treatment. Higher values of beneficial bacteria and lower values of harmful bacteria is better. Thus, it is expected that post-FMT, beneficial bacteria will increase and harmful bacteria decrease. |
| Baseline, 1 mo, 3 mo |
| Blood Lipid Profile | Blood measurement assessing the levels of lipid parameters such as cholesterol and LDL. Higher values for LDL and cholesterol may mean the person has dyslipidemia | Baseline, 1 mo, 3 mo |
| Change in Food Intake | Total daily energy intake from 3-day food record | Baseline, 1 mo, 3 mo |
| Change in Food Intake | Daily fat intake (% of energy) from 3-day food record | Baseline, 1 mo, 3 mo |
| Change in Food Intake | Daily carbohydrates intake (amount g/d, energy and % of energy) from 3-day food record | Baseline, 1 mo, 3 mo |
| Change in Food Intake | Daily protein intake (amount g/d, energy and % of energy) from 3-day food record | Baseline, 1 mo, 3 mo |
| Change in Food Intake | Daily fiber intake (g) from 3-day food record | Baseline, 1 mo, 3 mo |
| Physical Activity | Activity log, self-completed | Baseline, 1 mo, 3 mo |
| Stool Metabolomics | Metabolites and molecules in the stool sample measured using nuclear magnetic resonance spectroscopy. | Baseline, 1 mo, 3 mo |
| Serum Metabolomics | Nuclear magnetic resonance spectroscopy | Baseline, 1 mo, 3 mo |
| Background |
| Kelly CR, Kahn S, Kashyap P, Laine L, Rubin D, Atreja A, Moore T, Wu G. Update on Fecal Microbiota Transplantation 2015: Indications, Methodologies, Mechanisms, and Outlook. Gastroenterology. 2015 Jul;149(1):223-37. doi: 10.1053/j.gastro.2015.05.008. Epub 2015 May 15. |
| 23333862 | Background | Hamilton MJ, Weingarden AR, Unno T, Khoruts A, Sadowsky MJ. High-throughput DNA sequence analysis reveals stable engraftment of gut microbiota following transplantation of previously frozen fecal bacteria. Gut Microbes. 2013 Mar-Apr;4(2):125-35. doi: 10.4161/gmic.23571. Epub 2013 Jan 18. |
Fecal filtrate from 150 g of the recipient's own stool Fecal filtrate from 150 g of the recipient's own stool: 150 g stool from the recipient will be diluted in 0.9% normal saline to a total volume of 450 mL. Preparation from frozen stool. |
| BG002 | Total | Total of all reporting groups |
| Participants |
| No |
|
| Age, Continuous | Median | Inter-Quartile Range | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| HOMA-IR | Measure of insulin resistance. A person with HOMA-IR > 2.73 is consideered to have insulin resistance. The higher the HOMA-IR, the worse the insulin resistance. | Median | Inter-Quartile Range | Index |
|
Fecal filtrate from 150 g of the recipient's own stool Fecal filtrate from 150 g of the recipient's own stool: 150 g stool from the recipient will be diluted in 0.9% normal saline to a total volume of 450 mL. Preparation from frozen stool. |
|
|
| Secondary | Weight | Body weight (kg) | Posted | Median | Inter-Quartile Range | Kg | Baseline, 1 mo, 3 mo |
|
|
|
| Secondary | Body Mass Index | Weight (kg)/ height (m^2) | Posted | Median | Inter-Quartile Range | kg/m^2 | Baseline, 1 mo, 3 mo |
|
|
|
| Secondary | Appetite Score | Appetite score according to visual analog scale. Scores range from 0 to 10. In hunger, zero means not hungry at all. In prospective consumption, 0 means "don't think they can eat anything at all" and lower score is better. In sweet craving, zero means "they very much would like to eat something sweet", thus, higher score is better. | Posted | Median | Inter-Quartile Range | score on a scale of 1 to 10 | Baseline, 1 mo, 3 mo |
|
|
|
| Secondary | Quality of Life Questionnaire | RAND 36-Item Health Survey 1.0 (SF-36). It is a 36-item questionnaire that asks questions about physical functioning, bodily pain, emotional well-being, social functioning, energy/fatigue, and general health perceptions, role limitations due to physical health problems, role limitations due to personal or emotional problems. The lowest score is 0 and the highest score is 100. Higher score shows better overall quality of life. | Posted | Median | Inter-Quartile Range | score on a scale | Baseline, 3 mo |
|
|
|
| Secondary | Depression Score | Montgomery-Åsberg Depression Rating Scale (MADRS) is used in assessing severity od depressive episode. The score for each question is combined for the total score which ranges from 0 to 60. Zero means no depressive episode and 60 means severe depression. | Posted | Median | Inter-Quartile Range | score on a scale | Baseline, 3 mo |
|
|
|
| Secondary | Anxiety Score | Hamilton Anxiety Rating Scale (Ham-A) is a questionnaire that assesses anxiety. The scale is 0 to 30. 0 means no anxiety present and 30 means severe anxiety. | Posted | Median | Inter-Quartile Range | score on a scale | Baseline, 3 mo |
|
|
|
| Other Pre-specified | Hemoglobin A1c | Blood measurement which measures proportion of glycated hemoglobin to total hemoglobin. This measurement assesses the blood glucose control in the last 3 months. Generally, hemoglobin A1c < 0.060 is normal, 0.060 ≤ hemoglobin A1c <0.065 is prediabetic and ≥ 0.065 is diabetic. | Posted | Median | Inter-Quartile Range | ratio glycated Hb to total Hb | Baseline, 1 mo, 3 mo |
|
|
|
| Other Pre-specified | Change in Intestinal Microbiome in Stool, Composition | Measured by metagenomic sequencing. This measurement assesses the change in bacterial relative abundance level (in percentage) in the stool following the treatment. Higher values of beneficial bacteria and lower values of harmful bacteria is better. Thus, it is expected that post-FMT, beneficial bacteria will increase and harmful bacteria decrease. | Posted | Mean | Standard Error | change in percentage | Baseline, 1 mo, 3 mo |
|
|
|
| Other Pre-specified | Blood Lipid Profile | Blood measurement assessing the levels of lipid parameters such as cholesterol and LDL. Higher values for LDL and cholesterol may mean the person has dyslipidemia | Posted | Median | Inter-Quartile Range | mmol/L | Baseline, 1 mo, 3 mo |
|
|
|
| Other Pre-specified | Change in Food Intake | Total daily energy intake from 3-day food record | Posted | Median | Inter-Quartile Range | kcal | Baseline, 1 mo, 3 mo |
|
|
|
| Other Pre-specified | Change in Food Intake | Daily fat intake (% of energy) from 3-day food record | Posted | Median | Inter-Quartile Range | percentage of total energy intake | Baseline, 1 mo, 3 mo |
|
|
|
| Other Pre-specified | Change in Food Intake | Daily carbohydrates intake (amount g/d, energy and % of energy) from 3-day food record | Posted | Median | Inter-Quartile Range | percentage of total energy intake | Baseline, 1 mo, 3 mo |
|
|
|
| Other Pre-specified | Change in Food Intake | Daily protein intake (amount g/d, energy and % of energy) from 3-day food record | Posted | Median | Inter-Quartile Range | percentage of total energy intake | Baseline, 1 mo, 3 mo |
|
|
|
| Other Pre-specified | Change in Food Intake | Daily fiber intake (g) from 3-day food record | Posted | Median | Inter-Quartile Range | g | Baseline, 1 mo, 3 mo |
|
|
|
| Other Pre-specified | Physical Activity | Activity log, self-completed | Posted | Median | Inter-Quartile Range | min/day | Baseline, 1 mo, 3 mo |
|
|
|
| Other Pre-specified | Stool Metabolomics | Metabolites and molecules in the stool sample measured using nuclear magnetic resonance spectroscopy. | Posted | Mean | Standard Deviation | umol/g | Baseline, 1 mo, 3 mo |
|
|
|
| Other Pre-specified | Serum Metabolomics | Nuclear magnetic resonance spectroscopy | Posted | Median | Standard Deviation | umol/L | Baseline, 1 mo, 3 mo |
|
|
|
| 0 |
| 15 |
| 0 |
| 15 |
| 11 |
| 15 |
| EG001 | Autologous Control Group | Fecal filtrate from 150 g of the recipient's own stool Fecal filtrate from 150 g of the recipient's own stool: 150 g stool from the recipient will be diluted in 0.9% normal saline to a total volume of 450 mL. Preparation from frozen stool. | 0 | 13 | 0 | 13 | 10 | 13 |
| Abdominal pain | Gastrointestinal disorders | Systematic Assessment |
|
| Stomach cramp | Gastrointestinal disorders | Systematic Assessment |
|
| Blaoting | Gastrointestinal disorders | Systematic Assessment |
|
| Passing more gas than usual | Gastrointestinal disorders | Systematic Assessment |
|
| Nausea/vomiting | Gastrointestinal disorders | Systematic Assessment |
|
| Foul smelling stool | Gastrointestinal disorders | Systematic Assessment |
|
| Abdominal distension | Gastrointestinal disorders | Systematic Assessment |
|
| abdominal tenderness | Gastrointestinal disorders | Systematic Assessment |
|
| Incontinence | Gastrointestinal disorders | Systematic Assessment |
|
| Headache | General disorders | Systematic Assessment |
|
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| D009750 |
| Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D006946 | Hyperinsulinism |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D001523 | Mental Disorders |
| 3 mo |
|
| 3 mo |
|
| Hunger (Baseline) |
|
| Hunger (3 mo) |
|
| Sweet craving (Baseline) |
|
| Sweet craving (3 mo) |
|
| Emotional wellbeing (Baseline) |
|
| Emotional wellbeing (3 mo) |
|
| 3 mo |
|
| Clostridium spiroforme (Baseline to 1mo) |
|
| Flavonifractor plautii (Baseline to 1mo) |
|
| Collinsella massiliensis (Baseline to 1mo) |
|
| Escherichia coli (Baseline to 1mo) |
|
| Lactococcus lactis (Baseline to 1mo) |
|
| Bacteroides xylanisolvens (Baseline to 1mo) |
|
| Roseburia intestinalis (Baseline to 3mo) |
|
| Roseburia hominis (Baseline to 3mo) |
|
| Eubacterium eligens (Baseline to 3mo) |
|
| Alistipes putredinis (Baseline to 3mo) |
|
| Ruthenibacterium lactatiformans (Baseline to 3mo) |
|
| Blautia hydrogenotrophica (Baseline to 3mo) |
|
| LDL (Baseline) |
|
| LDL (1mo) |
|
| LDL (3mo) |
|
| 3 mo |
|
| 3 mo |
|
| 3 mo |
|
| 3 mo |
|
| 3 mo |
|
| 3 mo |
|
| Indole Acetic Acid (Baseline) |
|
| Indole Acetic Acid (3 mo) |
|
| Phenylacetic acid (Baseline) |
|
| Phenylacetic acid (3 mo) |
|
| Decenoylcarnitine (Baseline) |
|
| Decenoylcarnitine (3 mo) |
|
| Isoleucine (Baseline) |
|
| Isoleucine (3 mo) |
|
| Leucine (Baseline |
|
| Leucine (3 mo) |
|