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This study is a prospective, single-center, randomized, controlled, crossover intervention trial. A total of 60 participants, including 30 patients with obesity and 30 healthy controls, will be enrolled. Each participant will receive an isocaloric liquid meal challenge (glucose, fat, or protein) on three separate experimental days, with a washout period of at least 7 days between visits to eliminate carryover effects from the previous intervention. The primary objective is to investigate the association between brain functional patterns and plasma metabolic profiles following the ingestion of different macronutrients in patients with obesity, aiming to uncover potential neuro-metabolic imbalance features.
This study is a prospective, single-center, randomized, controlled, crossover intervention trial enrolling 60 participants, including 30 obese patients and 30 healthy control volunteers. Each participant will be randomly assigned to one of the six possible sequences of three macronutrient interventions (A: glucose, B: fat, C: protein)-namely ABC, ACB, BAC, BCA, CAB, or CBA-to ensure balanced allocation across intervention orders. Each participant will undergo one nutrient challenge on each of three separate experimental days, with at least a 7-day washout period between visits to minimize carryover effects from prior interventions. During the washout periods, participants are required to maintain stable habitual dietary patterns and avoid extreme diets, high-intensity exercise, irregular sleep schedules, and intake of additional nutritional supplements; adherence will be monitored via brief diet and activity logs.
The intervention consists of isocaloric (200 kcal) and isovolumetric (300 mL) liquid meals, specifically formulated as follows: Glucose arm: 50 g glucose powder dissolved in water to a final volume of 300 mL; Fat arm: 100 mL intralipid emulsion diluted with water to a final volume of 300 mL; Protein arm: 54 g whey protein powder dissolved in water to a final volume of 300 mL. On each experimental day, participants must arrive in a fasting state. Prior to nutrient administration, they will complete clinical laboratory tests, body composition assessment, hepatic fat quantification, and eating behavior questionnaires. During and after the intervention, participants will provide dynamic postprandial satiety ratings, multi-timepoint blood and stool samples (for untargeted metabolomic analysis), and undergo functional magnetic resonance imaging (fMRI) within a predefined postprandial time window. Finally, neuroimaging metrics, peripheral metabolomic profiles, and subjective satiety scores will be integrated through multidimensional correlation analyses to explore the neuro-metabolic coupling responses to different macronutrient challenges in obesity, thereby providing theoretical insights and potential targets for precision nutrition interventions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Glucose Challenge | Experimental | Participants receive a single 200 kcal liquid meal consisting of 50 g glucose powder dissolved in water to a final volume of 300 mL, administered 6 hours after consuming a standardized pre-load meal. |
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| Fat Challenge | Experimental | Participants receive a single 200 kcal liquid meal consisting of 100 mL intralipid emulsion diluted with water to a final volume of 300 mL, administered 6 hours after consuming a standardized pre-load meal. |
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| Protein Challenge | Experimental | Participants receive a single 200 kcal liquid meal consisting of 54 g whey protein isolate powder dissolved in water to a final volume of 300 mL, administered 6 hours after consuming a standardized pre-load meal. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Glucose Liquid Meal | Dietary Supplement | A standardized, isocaloric (200 kcal), isovolumetric (300 mL) liquid meal containing 50 g pure glucose. Administered orally 6 hours after a standardized pre-load meal. |
| Measure | Description | Time Frame |
|---|---|---|
| Acute Brain Functional Response to Macronutrient Challenges | Changes in whole-brain functional activation patterns assessed by blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI), comparing pre-challenge baseline with post-challenge scans acquired within 20 minutes after ingestion of glucose, fat, or protein. | Baseline (pre-challenge) and within 0-20 minutes post-challenge on each experimental day |
| Dynamic Plasma Metabolomic Response to Macronutrient Challenges | Temporal changes in plasma metabolic profiles characterized by untargeted metabolomic profiling, evaluating the evolution of metabolite concentrations across three time points: before intervention, 30 minutes post-intervention, and 120 minutes post-intervention, following single-dose challenges with glucose, fat, or protein. | Baseline (pre-challenge), 30 minutes post-challenge, and 120 minutes post-challenge on each experimental day. |
| Measure | Description | Time Frame |
|---|---|---|
| Temporal Changes in Subjective Satiety and Hunger Ratings | Subjective levels of satiety and hunger assessed using a standardized visual analog scale (VAS), with ratings collected at four time points: before nutrient challenge, immediately after ingestion (0 minutes), 30 minutes post-challenge, and 120 minutes post-challenge. | Pre-challenge, 0 minutes, 30 minutes, and 120 minutes post-challenge on each experimental day. |
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Inclusion Criteria:
Obese participants:
Healthy control participants:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yan Bi | Contact | 6-25-83-105302 | biyan@nju.edu.cn | |
| Zhou Zhang | Contact | 86-25-83-105302 | zhangzhou@smail.nju.edu.cn |
| Name | Affiliation | Role |
|---|---|---|
| Yan Bi | Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Endocrinology, Endocrine and Metabolic Disease Medical Center,Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University | Recruiting | Nanjing | Jiangsu | China 210008 | China |
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| ID | Term |
|---|---|
| D009765 | Obesity |
| D005247 | Feeding Behavior |
| ID | Term |
|---|---|
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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| Fat Liquid Meal | Dietary Supplement | A standardized, isocaloric (200 kcal), isovolumetric (300 mL) liquid meal prepared from 100 mL of intralipid emulsion diluted with water. Administered orally 6 hours after a standardized pre-load meal. |
|
| Protein Liquid Meal | Dietary Supplement | A standardized, isocaloric (200 kcal), isovolumetric (300 mL) liquid meal containing 54 g whey protein isolate powder. Administered orally 6 hours after a standardized pre-load meal. |
|
| Inter-group Differences in Brain Functional and Metabolic Responses Between Obese and Healthy Participants | Comparison of whole-brain fMRI activation patterns and plasma metabolomic profiles between obese participants and healthy controls following glucose, fat, or protein challenges, to evaluate group-level differences in neuro-metabolic responsiveness. | Baseline, within 0-20 minutes (fMRI), and 30/120 minutes (metabolomics) post-challenge on each experimental day |
| Changes in Gut Microbiota Composition and Alpha/Beta Diversity Following Macronutrient Challenges | Fecal samples collected approximately 24 hours before and 24 hours after each macronutrient challenge are analyzed via 16S rRNA gene sequencing (or metagenomic sequencing) to assess changes in gut microbial composition, alpha diversity (within-sample), and beta diversity (between-sample). | Approximately 24 hours before intervention and approximately 24 hours after intervention on each experimental day |
|
| D001835 |
| Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001522 | Behavior, Animal |
| D001519 | Behavior |