Non-alcoholic Fatty Liver Disease Clinical Trial
Official title:
A Pilot Study of Acarbose as Treatment for Pediatric Non-alcoholic Fatty Liver Disease (NAFLD)
The objective of this study is to demonstrate a reduction of intrahepatic fat as measured with Proton Magnetic Resonance Spectroscopy after 12 weeks administration of oral acarbose. The study will also examine the hypothesis of whether the chronic administration of acarbose in patients with NAFLD will influence postprandial substrate metabolism reflected in the RQ measured by indirect calorimetry.
The chronic administration of acarbose has been shown to improve insulin resistance and
reverse impaired glucose tolerance. Both these conditions, especially insulin resistance,
are physiologically associated with the development and progression of NAFLD. Therefore, we
hypothesized that the chronic administration of acarbose attenuates NAFLD by improving
glucose handling. This would be reflected in a reduction of intrahepatic fat accumulation.
Proton Magnetic Resonance Spectroscopy is a sensitive and non-invasive method to measure
changes in intrahepatic fat content. The primary endpoint of this study would be to
demonstrate a reduction of intrahepatic fat as measured with Proton Magnetic Resonance
Spectroscopy after 12 weeks administration of oral acarbose. Other relevant secondary
outcomes that have been previously demonstrated to be associated with improvement of NAFLD
included improvement of insulin resistance, normalizing of serum adiponectin, and a lowering
of serum Leptin.
A second intent of the study is to test the hypothesis of whether the chronic administration
of acarbose in patients with NAFLD will influence postprandial substrate metabolism
reflected in the RQ measured by indirect calorimetry. The consequence of insulin resistance
is a relative inhibition of fatty oxidation. However, the chronic administration of acarbose
improves insulin resistance and dampens the post-prandial surge in serum glucose and
insulin. These changes in glucose handling could possibly result in a shift towards a
pattern of preferential lipid oxidation. We anticipate either a lowering or blunting of the
postprandial RQ after chronic administration of acarbose for 3 months.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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