ClinicalTrials.gg
Not yet recruitingNCT07760909MASLDUpdated Aug 12, 2026

Metabolic Flux Analysis in Metabolic Dysfunction-Associated Steatotic Liver Disease

An interventional study of Bariatric surgery and Stable isotope tracer infusion in Metabolic Dysfunction-Associated Steatotic Liver Disease, Metabolic Dysfunction-Associated Steatohepatitis and Obesity, sponsored by Vanderbilt University Medical Center. Not yet recruiting. Open to participants aged 21 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-08-12.

Sponsored by Vanderbilt University Medical Center · Not applicable, Interventional, and Basic science

Phase
Not applicable
Study type
Interventional
Enrollment
20
Allocation
Not applicable
Ages
21 Years to 70 Years
Sex
All
01

Study summary

This prospective, single-center pilot study will evaluate metabolic flux dysregulation in adults with obesity and suspected or confirmed metabolic dysfunction-associated steatotic liver disease (MASLD) who are scheduled for protocol-eligible bariatric surgery at Vanderbilt University Medical Center. Participants will undergo research assessments before surgery, during the planned bariatric surgery encounter, and approximately 6 months after surgery. The study uses non-radioactive stable isotope tracer infusions, serial blood sampling, abdominal MRI/MRE, and research tissue specimens collected only during clinically planned bariatric surgery to quantify hepatic and extrahepatic metabolic fluxes. The primary objective is to determine how hepatic citric acid cycle flux and related metabolic pathways change after bariatric surgery and how these metabolic measures relate to liver fat, liver stiffness, and biopsy-graded MASLD/MASH severity.

Read the detailed description

MASLD and its progressive form MASH are associated with obesity, insulin resistance, altered hepatic substrate delivery, and changes in mitochondrial metabolism. However, the direction and significance of hepatic citric acid cycle flux changes in human MASLD remain unresolved. This study will apply in vivo metabolic flux analysis using non-radioactive stable isotope tracers to quantify hepatic and extrahepatic metabolic pathway activity in bariatric surgery participants before and after surgery.

Participants will complete three study timepoints. Approximately one week before surgery, participants will undergo fasting physical measurements, questionnaires, research blood collection, and abdominal MRI/MRE to quantify liver fat and stiffness. On the day of surgery, participants will receive intravenous infusions of [¹³C₃]lactate, [6,6-²H₂]-D-glucose, and [9,9-²H₂]palmitate for approximately 120 minutes with serial blood collection. During the clinically planned bariatric surgery, research tissue specimens may be collected from liver, omentum, subcutaneous adipose tissue, and skeletal muscle only if the surgeon determines collection can be performed safely without interfering with clinical care. Approximately 6 months after surgery, participants will repeat fasting physical measurements, questionnaires, MRI/MRE, stable isotope tracer infusion, and blood collection; no follow-up tissue biopsies will be collected.

Isotope enrichment patterns in plasma metabolites and tissue metabolites will be analyzed by mass spectrometry and modeled using metabolic flux analysis software to estimate hepatic citric acid cycle flux, gluconeogenesis, glucose turnover, free fatty acid turnover, lactate turnover, and selected extrahepatic metabolic fluxes. Liver fat and stiffness will be assessed by MRI/MRE, and intraoperative liver tissue will be scored for MASLD/MASH features using established histologic criteria.

02

Conditions studied

  • Metabolic Dysfunction-Associated Steatotic Liver Disease
  • Metabolic Dysfunction-Associated Steatohepatitis
  • Obesity
  • Bariatric Surgery

Keywords

  • MASLD
  • MASH
  • metabolic flux analysis
  • stable isotope tracer
  • bariatric surgery
  • Roux-en-Y gastric bypass
  • sleeve gastrectomy
  • liver fat
  • magnetic resonance elastography
  • citric acid cycle
  • gluconeogenesis
  • free fatty acid turnover
03

In context

Obesity

11,522 studies on the registry are indexed under Obesity; 2,033 are open to participants now.

This study's planned enrollment of 20 is below the median of 67 across 9,006 interventional studies indexed under Obesity.

Browse Obesity studies →

Lead sponsor

Vanderbilt University Medical Center is the lead sponsor of 833 studies on the registry; 155 are open to participants now.

Of its 125 completed or terminated interventional studies of FDA-regulated products, 92 (74%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
21 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Scheduled and clinically cleared for protocol-eligible bariatric surgery at Vanderbilt University Medical Center.
  • ≥40 kg/m², or BMI >35 kg/m² with at least one obesity-associated comorbidity, such as type 2 diabetes, cardiovascular disease, hypertension, hyperlipidemia, obstructive sleep apnea, MASLD, osteoarthritis, or polycystic ovarian syndrome.
  • Able and willing to complete study procedures, including , questionnaires, blood draws, MRI/MRE imaging, stable isotope tracer infusion, and research tissue collection during planned bariatric surgery.
  • Able to provide informed consent in English.

Exclusion criteria

Exclusion Criteria:

  • to MRI/MRE, including implanted cardiac defibrillator, pacemaker, or other MRI-incompatible implanted device.
  • Prior gastric or intestinal surgery, pancreatic surgery, or other prior surgery that, in the judgment of the study team or bariatric surgeon, would interfere with study procedures or outcome interpretation.
  • Active cancer or ongoing cancer treatment.
  • Presence or history of infection.
  • Alcohol use above study-defined limits: more than 14 alcoholic drinks per week for men or more than 7 alcoholic drinks per week for women, or illicit drug use that would interfere with safe participation or interpretation of study results.
  • Anemia or other hematologic condition that would increase risk from study blood collection.
  • Abnormal or cardiovascular finding that would increase risk from study procedures.
  • Impaired renal function or other clinically significant condition that would increase risk from study participation.
  • Known Wilson's disease, alpha-1 antitrypsin deficiency, hemochromatosis, or other non-MASLD chronic liver disease that would confound interpretation of study outcomes.
  • Any medical, surgical, or safety condition that, in the judgment of the PI, clinical co-investigator, CRC staff, anesthesia team, or bariatric surgeon, would make participation unsafe or interfere with completion of study procedures.
Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

05

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
20 participants (estimated)

Study arms

  • Experimental
    Bariatric Surgery Participants Undergoing Metabolic Flux Assessment

    Adults scheduled and clinically cleared for protocol-eligible bariatric surgery at VUMC will undergo research MRI/MRE, blood collection, non-radioactive stable isotope tracer infusions, and intraoperative research tissue collection during planned bariatric surgery, followed by repeat noninvasive metabolic assessment approximately 6 months after surgery.

    Procedure: Bariatric surgery · Other: Stable isotope tracer infusion · Diagnostic Test: MRI/MRE · Procedure: Research tissue collection during planned bariatric surgery

Interventions

  • ProcedureBariatric surgery

    Clinically indicated bariatric surgery, such as Roux-en-Y gastric bypass or sleeve gastrectomy, performed as part of standard clinical care.

    Also known as: Roux-en-Y-gastric byass, sleeve gastrectomey

  • OtherStable isotope tracer infusion

    Intravenous non-radioactive stable isotope tracers administered for research measurement of metabolic flux: \[¹³C₃\]lactate, \[6,6-²H₂\]-D-glucose, and \[9,9-²H₂\]palmitate.

  • Diagnostic testMRI/MRE

    Abdominal MRI proton density fat fraction and magnetic resonance elastography to assess hepatic fat and stiffness before surgery and approximately 6 months after surgery.

    Also known as: magnetic resonance imaging, magnetic resonance elastography

  • ProcedureResearch tissue collection during planned bariatric surgery

    Liver, omentum, subcutaneous adipose tissue, and skeletal muscle specimens collected only during clinically planned bariatric surgery and only if safe in the surgeon's judgment.

06

What researchers measure

Primary outcomes

  1. Change in hepatic citric acid cycle flux after bariatric surgery

    Change in hepatic citric acid cycle flux estimated from stable isotope enrichment patterns, including \[¹³C₃\]lactate-based measurements, before bariatric surgery and approximately 6 months after surgery.

    Time frame: Baseline/day of surgery to approximately 6 months post-surgery

Secondary outcomes

  1. Change in hepatic gluconeogenic flux

    Estimated from plasma glucose isotope enrichment and metabolic flux modeling

    Time frame: Baseline/day of surgery to ~6 months

  2. Change in endogenous glucose production

    Estimated using \[6,6-²H₂\]-D-glucose tracer dilution

    Time frame: Baseline/day of surgery to ~6 months

  3. Change in free fatty acid turnover

    Estimated using \[9,9-²H₂\]palmitate tracer dilution

    Time frame: Baseline/day of surgery to ~6 months

  4. Change in lactate turnover / lactate-related flux

    Estimated using stable isotope enrichment patterns

    Time frame: Baseline/day of surgery to ~6 months

  5. Liver fat by MRI-PDFF

    Hepatic fat fraction quantified by MRI-PDFF

    Time frame: Baseline to ~6 months

  6. Liver stiffness by MRE

    Liver stiffness quantified by magnetic resonance elastography

    Time frame: Baseline to ~6 months

  7. Histologic MASLD/MASH severity

    Liver biopsy scored for steatosis, inflammation, ballooning, fibrosis, and MASLD activity score

    Time frame: Intraoperative baseline only

  8. Extrahepatic metabolic fluxes

    Metabolic fluxes in skeletal muscle, omentum, and subcutaneous adipose tissue estimated from intraoperative tissue specimens

    Time frame: Intraoperative baseline only

  9. Serum inflammatory markers

    Research measurement of inflammatory markers including CRP, cytokines, adhesion molecules, and related biomarkers

    Time frame: Baseline/day of surgery; possibly ~6 months if collected

  10. Metabolic hormone profile

    Insulin, leptin, C-peptide, GLP-1, GIP, PYY, ghrelin

    Time frame: Baseline/day of surgery; possibly ~6 months if collected

  11. Bile acid profile

    Bile acids measured by LC-IM-MS

    Time frame: Baseline/day of surgery; possibly ~6 months if collected

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: Yes — De-identified or coded individual-level data and biospecimens may be shared for future research only as permitted by the informed consent document, IRB approval, institutional policy, data-use agreements, and applicable privacy protections. No direct identifiers will be included in publications, presentations, reports, or shared datasets.

Supporting information: Study protocol, Statistical analysis plan, Informed consent form, Clinical study report

Time frame: Data will be available within one year after study end.

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Oct 2026; primary completion for Sep 2029, 35 months later.

Of 3,680 non-industry interventional studies with no phase under Obesity, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 43. This study's planned 35 months is above that.

Counting every sponsor, half of 3,843 studies reached it within 22 months; a quarter within 10 and three quarters within 42.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 7, 2026
First posted
Aug 12, 2026
StartEst.
Oct 1, 2026
Primary completionEst.
Sep 30, 2029
CompletionEst.
Jan 1, 2060
Last update
Aug 12, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 12, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07760909
Responsible party
Charles R. Flynn (Associate Professor, Vanderbilt University Medical Center) — Principal investigator
First posted
Aug 12, 2026
Start date
Oct 1, 2026 (estimated)
Primary completion
Sep 30, 2029 (estimated)
Completion
Jan 1, 2060 (estimated)
Last update
Aug 12, 2026

Study contacts

Charles R Flynn, PhD
Contact
MASLD.research@vumc.org
615-343-8329
Charles R Flynn, PhD
principal investigator · Vanderbilt University Medical Center

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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