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Trial registered on ANZCTR
Registration number
ACTRN12621000001897
Ethics application status
Approved
Date submitted
17/08/2020
Date registered
7/01/2021
Date last updated
7/01/2021
Date data sharing statement initially provided
7/01/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
Characterising the Pre-diabetic Asian and Caucasian Phenotype: the ‘TOFI’ Profile – 3-year Follow-up
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Scientific title
Characterising the Pre-diabetic Asian and Caucasian Phenotype: the ‘TOFI’ Profile – 3-year Follow-up: identifying biomarkers of diabetic susceptibility and resilience using a metabolomics platform
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Secondary ID [1]
300823
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Nil
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Universal Trial Number (UTN)
U1111-1249-9953
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Trial acronym
TOFI_F/U
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Linked study record
This is a 3-year follow up study to ACTRN12616000362493
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Health condition
Health condition(s) or problem(s) studied:
Diabetes
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Condition category
Condition code
Diet and Nutrition
314954
314954
0
0
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Obesity
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Metabolic and Endocrine
314955
314955
0
0
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Diabetes
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
The cross-sectional TOFI Asia study recruited Asian Chinese and European Caucasian adults resident in 2016 in Auckland, New Zealand. Participants were across a wide range of age (18-70 years), body weight, BMI (body-mass index (BMI) between 20-45 kg/m2) and glycaemia; with both normoglycaemic and moderately hyperglycaemic (pre-diabetic) included. Current or prior diagnosis of type 2 diabetes (T2D) was an exclusion criterion. The cohorts were matched for gender, age and BMI. Phenotype characteristics were measured once in the fasted state and these included anthropometry, body composition including whole body, visceral and ectopic organ fat, and clinical blood biomarkers related to T2D risk, in addition to serum metabolomics and faecal microbiome. The anticipated duration of the assessments is approximately 2 hours
In order to determine whether these markers may predict who worsens towards and/or develops diabetes, longitudinal follow up will be conducted. The 3-year follow-up study will measure anthropometry and fasted blood samples once in the fasted state. Participants will also have once dual-energy x-ray absorptiometry (DXA) scan to determine total and regional body fat, and collect a stool/faecal sample, for gut microbiome.
100 female participants, due to gender differences in body composition, will additionally undertake a single Magnetic Resonance Imaging and Spectroscopy (MRI/S) scan, to determine ectopic and/or non-adipose tissue organ fat in pancreas and liver. They will also complete a short sub-maximal cardiorespiratory fitness (CRF) test. The MRI/S scan will take about 40 minutes to complete.
A subset of these women (n=25) who additionally also had their MRI/S scan will be invited to have a single intravenous glucose tolerance test (ivGTT) as a measure of insulin secretion in the fasted state. The test will take 1 hour and will involve
Will also recruit a new cohort of Asian Chinese and Caucasian participants, to the study, who will undergo baseline testing (as done in 2016 for the TOFI_Asia participants) and subsequent 3 year follow-up in 2023-24. All new participants will meet the following criteria: Asian (mainland Chinese; Hong Kong, Taiwan, Singapore or Malaysian Chinese; or Korean) or Caucasian European ethnicity, aged 18-70 years old, normal weight or overweight with a body mass index (BMI=weight/height2) of between 20-50kg/m2, but are otherwise healthy.
Participants will be matched for gender, age and BMI. Phenotype characteristics that will be measured will include anthropometry, body composition and clinical blood biomarkers related to T2D risk, in addition to serum metabolomics and faecal microbiome.
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Intervention code [1]
317154
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Not applicable
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Comparator / control treatment
Not applicable
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
323265
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Characterise the healthy vs prediabetic profile for type 2 diabetes based on blood biomarkers (including established biomarkers i.e., fasting plasma glucose, insulin, HbA1c, full lipid profile, liver function tests and novel metabolomic biomarkers) and body composition (using DeXA and MRI/S). This is a composite primary outcome of both blood biomarkers and body composition.
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Assessment method [1]
323265
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Timepoint [1]
323265
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3 years post-enrolment
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Primary outcome [2]
323266
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Analysis of pancreas and liver fat deposition using untargeted LC-MS methodology in a subgroup of 100 female participants.
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Assessment method [2]
323266
0
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Timepoint [2]
323266
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3 years post-enrolment
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Primary outcome [3]
326128
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Identify novel plasma metabolomic markers, that are predictive of pancreas and liver fat deposition and risk of developing type 2 diabetes in a subgroup of 100 female participants.
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Assessment method [3]
326128
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Timepoint [3]
326128
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3 years post-enrolment
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Secondary outcome [1]
381376
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Determine the impact of MRI determined pancreas and liver fat on pancreatic beta-cell function and insulin secretion using an intravenous glucose tolerance test (iVGTT) in a subgroup of 25.
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Assessment method [1]
381376
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Timepoint [1]
381376
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3 years post-enrolment.
2-stepped 30-minute tests with blood samples collected at -10, 0, 2, 4, 6, 10,25, 30, 32, 34, 36, 40, 55 and 60 minutes for iVGTT.
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Secondary outcome [2]
381377
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Determine cardiorespiratory fitness as assessed by the YMCA cycle ergometer submaximal test in 100 women.
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Assessment method [2]
381377
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Timepoint [2]
381377
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3 years post-enrolment.
Steady-state heart rate (SSHR) will be calculated as an average HR recorded during the 2nd and 3rd minute of each stage of the YMCA Cycle Ergometer Submaximal Exercise Test.
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Eligibility
Key inclusion criteria
Participants of both gender,
(i) between 18–70 years
(ii) BMI 20–45 kg/m2
(iii) both parents of the same ethnic origin, either European Caucasian or Asian Chinese (including mainland China, Singapore, Malaysia, Hong Kong, Taiwan, and Korea)
(iv) normo- or dysglycaemic (fasting plasma glucose, FPG: 5·6–6·9 mmol/L)
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Minimum age
18
Years
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Maximum age
70
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
*Recent body weight loss/gain >10%, within previous 3 months
*Recent bariatric surgery, within previous 6 months
*Significant current disease
*Pregnant or breastfeeding women
*Standard exclusions for DXA and MRI scanning techniques, including cardiac pacemaker
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
2/03/2020
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Date of last participant enrolment
Anticipated
30/06/2021
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Actual
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Date of last data collection
Anticipated
30/06/2024
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Actual
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Sample size
Target
400
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Accrual to date
39
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Final
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Recruitment outside Australia
Country [1]
22443
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New Zealand
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State/province [1]
22443
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Auckland
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Funding & Sponsors
Funding source category [1]
305281
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Government body
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Name [1]
305281
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National Science Challenge High Value Nutrition (HVN)
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Address [1]
305281
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Building 505
85 Park Road, Grafton
Auckland, 1023
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Country [1]
305281
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New Zealand
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Primary sponsor type
University
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Name
University of Auckland
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Address
Level 10, Building 620
49 Symonds St
Auckland
1010
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Country
New Zealand
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Secondary sponsor category [1]
305643
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None
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Name [1]
305643
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Address [1]
305643
0
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Country [1]
305643
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
305621
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Southern Health and Disability Ethics Committees
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Ethics committee address [1]
305621
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Ministry of Health Freyberg Building 20 Aitken Street PO Box 5013 Wellington 6011
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Ethics committee country [1]
305621
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New Zealand
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Date submitted for ethics approval [1]
305621
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27/10/2019
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Approval date [1]
305621
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26/02/2020
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Ethics approval number [1]
305621
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16/STH/23/AM09
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Summary
Brief summary
Background: People of Asian descent are at much higher risk of poor metabolic health and diabetes at a younger age and a lower body weight than those of European Caucasian descent. The reason why some individuals are more susceptible than others and what controls their diabetes risk may lie in the storage of body fat and may be identified through early changes in serum metabolite profile. Gaining even small amounts of body weight can lead to the fat ‘spilling over’ from adipose tissue and into important organs such as the muscle, liver and pancreas, which in turn may significantly increase risk of disease. Often known as the TOFI profile – ‘Thin on the Outside, Fat on the Inside’ – people who appear ostensibly slim and/or mildly overweight can develop diabetes whilst those who are very overweight and/or obese may not. Few predictive biomarkers of early diabetes risk and propensity to susceptibility or resilience have yet been determined. Objective: To investigate diabetic risk profile, susceptibility and resilience to weight gain and increasing adiposity in a population of Asian Chinese and Caucasian adults using body composition and metabolomic techniques; and, to conduct 3-year follow-up to determine whether these markers may predict who worsens towards and/or develops frank diabetes. Design: This is a longitudinal follow-up study of 400 participants, aged 18-70 years, of Asian Chinese (n=200) or Caucasian European (n=200) ethnicity. At baseline and 3-year follow-up, fasting blood samples will be collected to assess diabetic profile based on fasting plasma glucose, and also for untargeted metabolomics profiling; whole body and segmental fat free mass and adipose tissue fat mass will be measured on a single occasion using DEXA scanning; and in a subset of 100 individuals ectopic lipid storage in key organs including liver, pancreas and muscle will be measured using MRI/S.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Sally D Poppitt
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Address
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University of Auckland Human Nutrition Unit
18 Carrick Place
Mt Eden
Auckland 1024
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Country
100990
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New Zealand
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Phone
100990
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+64 96305160
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Fax
100990
0
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Email
100990
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[email protected]
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Contact person for public queries
Name
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Louise Lu
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Address
100991
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University of Auckland Human Nutrition Unit
18 Carrick Place
Mt Eden
Auckland 1024
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Country
100991
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New Zealand
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Phone
100991
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+64 96305160
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Fax
100991
0
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Email
100991
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[email protected]
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Contact person for scientific queries
Name
100992
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Ivana Sequeira
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Address
100992
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University of Auckland Human Nutrition Unit
18 Carrick Place
Mt Eden
Auckland 1024
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Country
100992
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New Zealand
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Phone
100992
0
+64 96305160
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Fax
100992
0
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Email
100992
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
This is in accordance to National Health and Disability Ethics Committees application that all data generated will only be used for this study only. However, if this is necessary additional consent will be obtained from participants to allow the use of data for other studies.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
7404
Study protocol
379483-(Uploaded-19-03-2020-13-11-29)-Study-related document.docx
7405
Informed consent form
379483-(Uploaded-19-03-2020-13-11-51)-Study-related document.docx
7406
Ethical approval
379483-(Uploaded-19-03-2020-13-12-17)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF