Metabolic and genetic response to probiotics supplementation in patients with diabetic nephropathy: a randomized, double-blind, placebo-controlled trial

Abstract

This study was carried out to evaluate the effects of probiotics administration on the metabolic and genetic profiles in patients with diabetic nephropathy (DN). This was a randomized, placebo-controlled clinical trial with homeostasis model of assessment-estimated insulin resistance (HOMA-IR) as the primary and other metabolic profiles, and biomarkers of inflammation and oxidative stress as the secondary outcomes. This randomized, double-blind, placebo-controlled clinical trial was performed on 60 patients with DN. The patients were randomly assigned into two groups to receive either 8 × 109 CFU day-1 probiotic supplements or placebo (n = 30 in each group) for 12 weeks. Fasting blood was collected at the baseline and end of intervention to measure glycemic control, lipid profiles, biomarkers of inflammation and oxidative stress. Multiple linear regression models were used to assess the treatment effects on the outcomes adjusting for confounding variables. Probiotics supplementation, compared with the placebo, resulted in a significant reduction in fasting plasma glucose (P = 0.01), serum insulin concentrations (P = 0.01) and HOMA-IR (P = 0.007), and a significant increase in the quantitative insulin sensitivity check index (P = 0.04). Additionally, compared with the placebo, probiotic intake resulted in a significant reduction in triglycerides (P = 0.001) and total-/HDL-cholesterol ratio (P < 0.001), and a significant increase in HDL-cholesterol levels (P < 0.001). Supplementation with probiotics, compared with the placebo, was associated with a significant reduction in high-sensitivity C-reactive protein (P = 0.001), malondialdehyde (P < 0.001) and advanced glycation end products (P < 0.001), and a significant elevation in plasma total glutathione (P < 0.001). Overall, our study indicated that probiotics supplementation had beneficial effects on glycemic control and markers of cardio-metabolic risk.

Probiotics ameliorates glycemic control of patients with diabetic nephropathy: A randomized clinical study

“…43 Another study showed that probiotic supplementation had beneficial effects on glycemic control and markers of cardiometabolic risk. 44 A meta-analysis showed that probiotic supplementation decreased serum insulin and insulin resistance, but it had no beneficial effect regarding kidney function, body weight and lipid profiles, with a moderate positive effect regarding some oxidative stress biomarkers. 45 Another meta-analysis showed the benefits of probiotic supplementation on the reduction of inflammation, oxidative stress and on the amelioration of renal function biomarkers in subjects with diabetic nephropathy.…”

“…It was reported that probiotic honey consumption for 12 weeks among DN patients had beneficial effects on insulin metabolism, total‐/HDL‐cholesterol, serum hs‐CRP, and plasma MDA levels, but did not affect other metabolic profiles 43 . Another study showed that probiotic supplementation had beneficial effects on glycemic control and markers of cardiometabolic risk 44 . A meta‐analysis showed that probiotic supplementation decreased serum insulin and insulin resistance, but it had no beneficial effect regarding kidney function, body weight and lipid profiles, with a moderate positive effect regarding some oxidative stress biomarkers 45 .…”

A Mini-Review of Human Studies on Cholesterol-Lowering Properties of Probiotics

“…The increase in insulin sensitivity and plasma total glutathione, and decrease in FBG, HOMA-IR values, and malondialdehyde, high-sensitive C-reactive protein were observed in the probiotic-treated group. The results suggested that probiotic consumption improved the cardiovascular diseases risk factors in DN patients [37].…”

“…Based on the randomized, placebo-controlled, double-blind studies [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] reviewed in the present article, the hypocholesterolemic effect of the probiotics was not significantly influenced by the diet. Studies reported based on the intervention of single-strain probiotic (E. faecium M-74 along with selenium [27]; Saccharomyces cerevisiae var.…”

“…Studies based on the intervention of multi-genus, multi-species, multi-strain (strains of same species) probiotic preparation has been reported with positive effect on lipid profile [24][25][26]28,[31][32][33][34][36][37][38][39]47,48], while several studies reported no effect of multi-genus and multi-species probiotic intervention on the lipid profile [55][56][57][58][59][60][61][62][63]. Even though intervention of Ecologic ® Barrier (B. bifidum W23, B. lactis W51, B. lactis W52, L. acidophilus W37, L. brevis W63, L. casei W56, L. salivarius W24, Lactococcus lactis W19 and W58) exhibit hypocholesterolemic effect on different subjects (individuals with T2D [38]; obese postmenopausal women [39]) with different intervention duration (six months [38]; 12 weeks [39]), dosage of probiotic mixture does not influence the cholesterol-lowering ability of the probiotic mixture.…”