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ArticleJMIR research protocols2025

Metabolic Flexibility to Predict Lifestyle Interventions Outcomes (MEPHISTO): Protocol for Predictive Validation Study and Randomized Controlled Trial.

Monika Ludlova, Kateřina Koudelková, Jitka Pallova, Barbora Koudelkova, Michaela Siklova, Monika Cahova, Tomas Vetrovsky, Michal Steffl, Jan Gojda

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in JMIR research protocols, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06329349 (Whole Body and Gut Microbiome Metabolic Flexibility to Predict Lifestyle Intervention Outcomes), which is not on this map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06329349 narecruitingnot on this map

Whole Body and Gut Microbiome Metabolic Flexibility to Predict Lifestyle Intervention Outcomes

TypeinterventionalSponsorCharles University, Czech RepublicRan2024 to 2026Enrolled30ConditionsObesityArmsExercise, Combined Exercise + Diet
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Monika Ludlova *Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic.ORCID 0009-0008-6796-4847
Kateřina Koudelková *Clinical Research Department, Kralovske Vinohrady University Hospital and Third Faculty of Medicine, Charles University, Prague, Czech Republic.ORCID 0000-0003-2053-9698
Jitka Pallova *Clinical Research Department, Kralovske Vinohrady University Hospital and Third Faculty of Medicine, Charles University, Prague, Czech Republic.ORCID 0009-0002-2971-1845
Barbora Koudelkova *Clinical Research Department, Kralovske Vinohrady University Hospital and Third Faculty of Medicine, Charles University, Prague, Czech Republic.ORCID 0009-0006-1027-8518
Michaela Siklova *Department of Pathophysiology, Centre for Research on Diabetes, Metabolism and Nutrition, Third Faculty of Medicine, Charles University, Prague, Czech Republic.ORCID 0000-0003-0489-1069
Monika Cahova *First Faculty of Medicine, Institute of Clinical and Experimental Medicine, Prague, Czech Republic.ORCID 0000-0003-2640-5084
Tomas Vetrovsky *Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic.ORCID 0000-0003-2529-7069
Michal Steffl *Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic.ORCID 0000-0001-7297-8145
Jan Gojda *Clinical Research Department, Kralovske Vinohrady University Hospital and Third Faculty of Medicine, Charles University, Prague, Czech Republic.ORCID 0000-0002-7995-5947

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWeight loss is a cornerstone of obesity treatment and diabetes mellitus type 2 (T2D) prevention, but its implementation in clinical practice is limited by its perceived burden and variability in response. Personalizing interventions to increase their success rate is an unmet clinical need.

objectiveIdentification of predictive factors associated with successful weight loss after sequential exercise in women with obesity.

methodsThe study will consist of a 2-stage analytical approach, including a predictive validation study and a 2:1 randomized cross-over controlled trial. Women aged 25-45 years with obesity (BMI>30) will be included in the study. The intervention will consist of a progressive protocol of aerobic exercise on a treadmill and a bicycle ergometer. We will measure weight loss in terms of fat mass (FM) and fat-free mass (FFM), metabolic flexibility (MetFlex) as ΔRQ (change in respiratory quotient (VCO2/VO2) between basal and insulin-stimulated state during glucose clamp), insulin sensitivity, glucose tolerance, hemoglobin A

resultsRecruitment for the trial began in January 2024. A total of 12 participants were enrolled and randomized. Among them 6 participants have completed the first phase of the A-arm and 6 participants have completed the control period of the B-arm and their intervention is ongoing. Recruitment is ongoing. We expect the preliminary data from this study to be completed in 2026.

conclusionsThis intervention will investigate whether whole body and gut MetFlex can be further explored and used as ex ante predictors of successful weight loss following exercise intervention, providing proof of concept and paving the way for personalized lifestyle interventions.

trial registrationClinicalTrials.gov NCT06329349; https://clinicaltrials.gov/study/NCT06329349. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/67570.

Indexed as

Life StyleObesityAdultCross-Over StudiesDiabetes Mellitus, Type 2ExerciseFemaleHumansInsulin ResistanceMiddle AgedRandomized Controlled Trials as TopicTreatment OutcomeWeight Lossdiabetesendocrinologyexercisegut microbiotametabolic flexibilityobesityoverweightphysical activityprotocolrandomized control trialvalidation studyweight loss

Identifiers

PMID40340957
PMCPMC12099273

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.