Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Obesity and metabolic dysfunction-associated steatotic liver disease (MASLD) accelerate the appearance of arterial stiffness due to inflammatory and oxidative stress mechanisms producing increased vascular tone and increasing the risk of cardiovascular disease. This arterial stiffness can be measured through pulse wave velocity (PWV). Obesity and MAFLD have multifactorial components, high fructose diet and sedentary lifestyle are causing the onset of these diseases earlier in life such as in adolescence. L-citrulline, a non-protein amino acid, has shown positive effects on improving nitric oxide synthesis which improves endothelial function, as well as results on the metabolic profile in MASLD. High intensity interval training (HIIT) has also shown benefits on endothelial function improving the metabolic profile of people with obesity and MASLD with the advantage of decreasing the time required to perform the physical activity. A clinical study will be conducted with 45 adolescents (15-19 years old) with MASLD and the participants will be divided into 3 groups to perform HIIT and supplement with citrulline or placebo for 12 weeks.
The investigators hypothesize that citrulline and HIIT have additive effects on endothelial function in people with obesity and MASLD, in addition to improving metabolic, lipid and hepatic steatosis profile. the researcher´s aim is to evaluate the effect of citrulline and HIIT on arterial stiffness assessed by PWV in adolescents with MASLD. For this the investigators will perform a randomized, double-blind clinical study in 45 adolescents with MASLD and obesity, who will be supplemented with 6 g per day with L-citrulline or placebo (Carboxymethylcellulose) and will perform HIIT sessions for 12 weeks. At the beginning and at the end of the intervention, the level of arterial stiffness by means of PWV, body composition, biochemical and metabolic data, as well as the degree of hepatic steatosis will be evaluated.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| L-Cit + HIIT | Active Comparator | adolescents will be supplemented with 6 g/day of L-citrulline and 3 sessions per week of HIIT for 12 weeks |
|
| L-Cit | Active Comparator | adolescents will be supplemented with 6 g/day of L-citrulline but without do exercise for 12 weeks |
|
| Placebo + HIIT | Placebo Comparator | adolescents will be supplemented with 6 g/day of Carboxymethyl cellulose and 3 sessions per week of HIIT for 12 weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| L-citrulline | Dietary Supplement | oral supplementation of pure L-citrulline (6 g) for twelve weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| Arterial Stiffness | The degree of arterial stiffness will be evaluated by oscillometric device (Mobil-O Graph). This device assesses Pulse Wave Velocity | 12 weeks |
| Reflected Wave | The Augmentation Index (AIx) measures the percentage of the pressure increase that is caused by the premature arrival of the reflected wave and is expressed as the ratio of PAo and PP multiplied by 100. AIx@75 is AIx corrected to a heart rate of 75 beats per minute. The Mobil-O Graph device also evaluates AIx@75 | 12 weeks |
| Degree of hepatic steatosis | The degree of hepatic steatosis will be evaluated by abdominal ultrasound. It will be diagnosed as:
| 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Glucose metabolism: glucose | Glucose will be evaluated by the Lakeside glucose oxidase method (GOD-PAPTM). | 12 weeks |
| Glycated hemoglobin (HbA1c) | Glycated hemoglobin (HbA1c) will be measured by reflectance spectrophotometry, by boronic acid affinity. |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Ma. Eugenia Garay-Sevilla, PhD | Universidad de Guanajuato | Principal Investigator |
| Alan Arturo Rodriguez-Carrillo, Bachelor | Universidad de Guanajuato | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universidad de Guanajuato | León | Guanajuato | 37000 | Mexico |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39940261 | Derived | Rodriguez-Carrillo AA, Espinoza-Vargas MR, Vargas-Ortiz K, Ibarra-Reynoso LDR, Olvera-Juarez M, Gomez-Ojeda A, Garay-Sevilla ME, Figueroa A. Impact of L-Citrulline Supplementation and HIIT on Lipid Profile, Arterial Stiffness, and Fat Mass in Obese Adolescents with Metabolic-Dysfunction-Associated Fatty Liver Disease: A Randomized Clinical Trial. Nutrients. 2025 Jan 23;17(3):402. doi: 10.3390/nu17030402. |
Not provided
Not provided
At the request of the researcher
Not provided
Not provided
Not provided
Not provided
Not provided
An intervention with exercise in modality of High-Intensity Interval Training (HIIT) and Oral administration of L-citrulline (L-cit) or placebo (Pl) as follows:
Group L-cit + HIIT: capsules of 6 g of citrulline will be supplemented per day, distributed as 3 g (4 capsules) in the morning before the first meal and 3 g in the evening before sleep for a period of 12 weeks. The sessions of HIIT will be made 3 days per week in a stationary bicycle Group Pl + HIIT: Carboxymethyl cellulose will be used as placebo. 4 capsules will be taken in the morning before the first meal and 4 capsules at night before going to sleep for a period of 12 weeks. The sessions of HIIT will be made 3 days per week in a stationary bicycle.
Group L-cit without HIIT: capsules of citrulline will be supplemented per day, distributed as 3 g (4 capsules) in the morning before the first meal and 3 g (4 capsules) in the evening before sleep for a period of 12 weeks. This group will not made exercise.
Not provided
Not provided
The selection of which group each adolescent will belong to, will be made by randomization by computer numbers by a researcher from the department of medical sciences of the University of Guanajuato, who is not involved in treatment and follow-up. The researcher will designated into a placebo or L-cit group. The investigator and the participants will not know the group which they belong.
| Carboxymethyl cellulose | Dietary Supplement | oral supplementation of Carboxymethyl cellulose (6 g) as a placebo, for twelve weeks |
|
|
| High Intensity Intervals Training | Other | participants will have sessions 3 days a week for twelve weeks |
|
|
| 12 weeks |
| Insuline Resistance | Insulin level will be measured by ELISA (ALPCO) method. The Homeostatic Model Assessment Index (HOMA-IR) will be calculated to determine insulin resistance. | 12 weeks |
| Lipid profile | The lipid profile will be measured by the modified Huang method. | 12 weeks |
| VO2max | VO2max is a measure of aerobic exercise capacity. It will be performed on a cycloergometer. Every 2 minutes 0.5 kp will be increased and HR will be measured minute by minute with a portable monitor (Polar HO1). When the participant no longer maintains the 60 rpm cadence or reaches the maximum perceived exertion on the modified Borg scale (9 or 10), the test is terminated. | 12 weeks |
| Arterial Pressure | Is pressure exerted by the blood on the artery wall. The mobil-O Graph also evaluates arterial pressure and reports it as Dyastolic Pressure (DAP), Systolic Pressure (SAP) and Mean Arterial Pressure (MAP) | 12 weeks |
| Body composition | Bioelectrical impedance will be used to assess total body composition as fat free mass (FFM), fat mass (FM) and total body water, using the standard configuration. The portable, multi-frequency In body S10 device will be used and it reports body composition in percentage (%) | 12 weeks |
| ID | Term |
|---|---|
| D063766 | Pediatric Obesity |
| D009765 | Obesity |
| ID | Term |
|---|---|
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
Not provided
Not provided
| ID | Term |
|---|---|
| D002956 | Citrulline |
| D002266 | Carboxymethylcellulose Sodium |
| ID | Term |
|---|---|
| D000599 | Amino Acids, Diamino |
| D000596 | Amino Acids |
| D000602 | Amino Acids, Peptides, and Proteins |
| D008747 | Methylcellulose |
| D002482 | Cellulose |
| D005936 | Glucans |
| D011134 | Polysaccharides |
| D002241 | Carbohydrates |
Not provided
Not provided