Overview
This study aims to determine the daily rate of endogenous synthesis of oxalate using fasted urine collection and a low-oxalate controlled diet in patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).
Description
Urinary oxalate excretion is derived from both dietary sources and endogenous synthesis. This study will use a low-oxalate controlled diet, repeat fasted urine collections and 24-hr urine collections on a low-oxalate diet, to determine the daily rate of endogenous oxalate synthesis in individuals with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).
Eligibility
Inclusion Criteria:
- age >18 years
- History of MASLD, with liver fat content > 5%
- Normal kidney function
- Stable medication for at least 1 month for diabetes mellitus if any
- Willingess to ingest fixed diets and stop dietary supplements for the study and come to UAB for visits
Exclusion Criteria:
- Age < 18 years
- Inaccurate 24-hour urine collections
- Liver fat content <5%
- Liver cirrhosis
- Evidence of other chronic liver disease, viral hepatitis
- history of alcoholism within 2 years of enrollment
- Contra-indication to Magnetic Resonance Imaging
- Chronic kidney disease with estimated Glomerular Filtration rate < 60 ml/min/1.73m2
- Type 1 Diabetes Mellitus or treatment with insulin
- Uncontrolled diabetes
- Pregnancy, lactation or intention to be
- Uncontrolled hypertension
- Use of weight loss medication, SGLT2 inhibitors, GLP-1 receptor agonists, osteoporosis medication, chronic NSAID
- History of gastric or intestinal surgery or resection that could potentially alter oxalate absorption
- Chronic fat malabsorption
- Use of immunosuppressive medications
- Known immuno-compromised status
- Active malignancy or treatment for malignanacy within the last 12 months