Endoscopic Gastric Reduction of Gastric Mucosa in Obesity

Obesity, Morbid Clinical Trial

— ETO  

Official title:

Impact of Endoscopic Gastric Reduction of Ghrelin Receptors Rich Gastric Mucosa on Obesity and Metabolic Syndrome: a Randomized Controlled Trial

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06231251
• Other study ID #: 9352
• Status: Recruiting
• Phase: N/A
• Start date: December 1, 2023
• Est. completion date: December 1, 2024

Study information

• Verified date: January 2024
• Source: Zagazig University
• Contact: Amr S Hanafy
• Phone: +201100061861
• Email: amrhanafy[@]zu.edu.eg
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

In the stomach, the ghrelin-containing cells are more abundant in the fundus than in the pylorus originally termed X/A-like cells. These X/A-like cells account for approximately 20 % of the endocrine cell population in adult oxyntic glands. Ghrelin enhances the secretion of growth hormone, the stimulation of appetite and food intake, the modulation of gastric acid secretion & motility and the endocrine and exocrine pancreatic secretions.

Description:

Ghrelin is 28 amino acid peptide hormone, approximately 70 % of circulating ghrelin is secreted by the stomach, with most of the remainder originating in duodenum, jejunum, and ileum. Lower amount of secretion outside the gut, including hypothalamus (arcuate nucleus and paraventricular nucleus), pituitary, lung, adrenal cortex, kidney, bone, testis, placenta and pancreatic islet cells Ghrelin enhances the secretion of growth hormone, the stimulation of appetite and food intake, the modulation of gastric acid secretion & motility and the endocrine and exocrine pancreatic secretions. Synthetic ghrelin imitative was shown to increase fat deposition and appetite through an action at the level of the hypothalamus arcuate nucleus mainly the orexigenic neuropeptide Y (NPY) neurons. Alterations of ghrelin play an important role in appetite fluctuation following meals. The secretion of ghrelin by the stomach depends largely on the nutritional state. Ghrelin levels show pre-prandial increases and postprandial decreases. Low systemic ghrelin levels have been reported in untreated hyperthyroidism, in male hypogonadism, in the polycystic ovary syndrome, or after total gastrectomy [5, 6].

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 48
• Est. completion date: December 1, 2024
• Est. primary completion date: September 13, 2024
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 50 Years

Eligibility

Inclusion Criteria:

• body mass index more than 25
• diagnosis of diabetes mellitus.
• diagnosis of cardio-metabolic syndrome.
• fatty liver disease diagnosed by abdominal ultrasound.

Exclusion Criteria:

• use of drugs which induce insulin resistance, diabetes and hepatic steatosis.
• excess alcohol consumption.
• chronic gastritis, active peptic ulcer.
• malignancy.
• depression and severe psychological disorders
• inability to give informed consent.
• coagulopathy (INR more than 1.5, platelets less than 50000 per cmm).
• severe cardiopulmonary comorbidity.

Related Conditions & MeSH terms

• Endoscopy
• Obesity
• Obesity, Morbid

Intervention

Other:
• upper gastrointestinal endoscopy
reduction of ghrelin rich gastric mucosa with band ligation or argon plasma

Locations

Country	Name	City	State
Egypt	Zagazig University	Zagazig	Sharkia

Sponsors (1)

Lead Sponsor	Collaborator
Zagazig University

Country where clinical trial is conducted

Egypt, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Number of patients with improved insulin resistance	significant decrease in insulin resistance through assessing Homeostatic Model Assessment for Insulin Resistance, calculated by using the following formula: fasting glucose (mg/dL) X fasting insulin (µU/mL) / 405	6 months
Primary	Number of patients with significant weight reduction	significant weight reduction of more than 10% of baseline body weight measured in kilograms	6 month