RecruitingPhase 2NCT07097506

Effect of Ketone Esters on Liver Fat Content and Metabolic Function

Effect of Ketone Esters on Liver Fat and Metabolic Function in Adolescents With Obesity and MASLD

Sponsor

Washington University School of Medicine

Enrollment

40 participants

Start Date

Sep 26, 2025

Study Type

INTERVENTIONAL

Conditions

Obesity Overweight (BMI > 25)MASLD - Metabolic Dysfunction-Associated Steatotic Liver Disease

Summary

The goal of this clinical trial is to determine whether ingestion of a ketone ester drink helps improve liver health and blood glucose control. Ketones are a type of energy source made by the body during times of weight loss, low carbohydrate intake and starvation. People enrolled in this study will be randomly assigned (by chance, like the flip of a coin) to one of two groups: Group 1: Ketone ester drink consumed daily for 6 weeks. Group 2: Placebo drink consumed daily for 6 weeks.

Eligibility

Min Age: 18 YearsMax Age: 25 Years

Inclusion Criteria3

Age: ≥18 and ≤25 years;
BMI 25.0 - 44.9 kg/m2;
Intrahepatic triglyceride content \>5% assessed by using magnetic resonance imaging-proton density fat fraction (MRI-PDFF).

Exclusion Criteria19

HbA1C ≥6.5%;
taking dietary supplements or medications known to affect our study outcomes including corticosteroids and other drugs associated with steatosis (metformin use will be allowable if participants have taken a stable dose for at least 3 months without any gastrointestinal-related symptoms);
active eating disorder, any anaphylactic food allergy and/or consuming a very-low-carbohydrate (\<50 g/day) diet;
Fibroscan controlled attenuation parameter (CAP) score \<240 dB/m assessed within last 2 months before entering the study;
recent (\<2 months) history of moderate-severe nausea, vomiting, diarrhea, or other significant gastrointestinal symptoms;
consume tobacco products, excessive alcohol (females: \>14 drinks/week; males: \>21 drinks/week), or illegal drugs determined by medical history;
evidence of significant active organ system dysfunction, liver disease other than MASLD (e.g., Wilson disease, viral hepatitis, inborn errors of metabolism, or alpha-1 antitrypsin deficiency) or cirrhosis as a results of any condition or disease;
have had bariatric surgery or plan to have endoscopic or bariatric surgery therapy for obesity;
have undergone organ transplantation;
have HIV and any other type of congenital or acquired lipodystrophy;
unwilling or unable to provide informed consent;
major psychiatric illness;
metal implants that are not MRI-compatible;
pregnancy, as determined by a urine HCG screening test assessed performed at all screening, baseline testing, and follow-up visits. In addition, male and female participants of reproductive and childbearing age who wish to enroll will be required to agree to use contraception throughout the study period, and for 30 days after the last dose of C8 ketone di-ester;
female participants who are currently lactating;
Structured exercise: ≥75 min/wk of vigorous exercise (e.g., jogging, activity that causes heavy breathing and sweating) or ≥200 min/wk of low intensity physical activity (e.g., brisk walking);
Unstable weight (\>3% change during the last 2 months before entering the study);
Anemia (hemoglobin \<10.5 g/dL in females and \<11.0 g/dL in males);
Unable or unwilling to follow the study protocol or who, for any reason, is considered an inappropriate candidate for the study by the research team.