Clinical trial NCT01634698: Relative-dose-response Test (RDR) Adaptation for Chronic Liver Disease
Official title: Responsiveness of RDR Test to Assess Hepatic Vitamin A Stores in Chronic Liver Disease
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Chronic Liver Disease
Keywords: chronic liver disease
cirrhosis
vitamin A
RDR test
retinol-binding protein
Lead sponsor: Universidade Federal do Rio de Janeiro
Sponsor class: OTHER
First posted: 2012-07-06
Enrollment: 178
Sex: ALL
Minimum age (years): 20
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: DIAGNOSTIC

Brief summary: The relative-dose-response test (RDR) is considered to be the most accurate method for evaluating vitamin A nutritional status (VANS) in patients suffering from liver disease, as it infers the reserves of the vitamin in the liver. However, for the RDR test to reflect VANS in patients suffering from chronic liver disease, factors inherent to the disease need to be considered, such as possible malabsorption, advanced age, a drop in synthesis and/or the release of retinol binding protein (RBP), which would result in an inadequate response to the RDR test. Thus, the objective of present study is to assess the adequacy of two different protocol for using the RDR test in patients with cirrhosis and cirrhosis-related hepatocellular carcinoma.

Methods: The sample group was comprised of 178 patients at Federal University of Rio de Janeiro University Hospital (111 men) with several etiologies of liver cirrhosis at different stages in the progression of the disease. They were sorted into two groups, according to the retinyl palmitate dosage (1500 IU or 2500 IU) received at T0 (blood sample taken following a 12-hour fast). Following supplementation, the investigators took further blood samples five and seven hours later (T5 and T7). The investigators assessed VANS via concentrations of serum retinol and RBP, as well as by way of the RDR test. The cutoff points the investigators used for denoting inadequacy in the indicators retinol and RDR were, respectively, \< 1.05 µmol/L and ≥ 20%. To classify the degrees of severity of the disease the investigators used the criteria established by Child \& Pugh (1973).


Eligibility criteria: Inclusion Criteria:

* diagnosis of liver cirrhosis of viral etiology, alcoholic or metabolic action

Exclusion Criteria:

* malabsorption syndromes
* moderate or severe infection
* diabetes mellitus using insulin renal, cardiac or respiratory
* therapeutic doses of vitamin A in the 6 months prior to data collection

Primary outcomes:
measure: Change from Baseline in retinol status (RDR test) at 5 and/or 7 hour after supplementation
timeFrame: RDR will be calculated for the two intervention groups (1500 or 2500 IU vitamin A), for the two moments of blood sampling, 5 and 7 hours after supplementation.
Secondary outcomes:
measure: serum retinol-binding protein (RBP)
timeFrame: RBP were analyzed at baseline, 5 and 7 hours after supplementation as a variable that explain the appropriate response or failure to respond to the RDR test.
Other outcomes:
Locations:
city: Rio de Janeiro
country: Brazil
facility: Gabriela Villaça Chaves
state: RJ
Study officials:
affiliation: Universidade Federal do Rio de Janeiro
name: Gabriela V Chaves, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Peres WA, Chaves GV, Goncalves JC, Ramalho A, Coelho HS. Vitamin A deficiency in patients with hepatitis C virus-related chronic liver disease. Br J Nutr. 2011 Dec;106(11):1724-31. doi: 10.1017/S0007114511002145. Epub 2011 Jun 8.