The effects of probiotic supplementation on metabolic status in type 2 diabetic patients with coronary heart disease

Abstract

BackgroundThis study was conducted to evaluate the effects of probiotic supplementation on metabolic profiles in diabetic patients with coronary heart disease (CHD).MethodsThis randomized, double-blind, placebo-controlled trial was performed among 60 diabetic patients with CHD, aged 40–85 years at a cardiology clinic in Kashan, Iran, from October 2017 through January 2018. Patients were randomly divided into two groups to take either probiotic supplements (n = 30) or placebo (n = 30) for 12 weeks. Fasting blood samples were taken at the beginning of the study and after the 12-week intervention to determine related markers.ResultsAfter 12-week intervention, probiotic supplementation significantly decreased fasting plasma glucose (β − 20.02 mg/dL; 95% CI − 33.86, − 6.17; P = 0.005), insulin (β − 2.09 µIU/mL; 95% CI − 3.77, − 0.41; P = 0.01), insulin resistance (β − 0.50; 95% CI − 0.96, − 0.03; P = 0.03) and total-/HDL-cholesterol ratio (β − 0.27; 95% CI − 0.52, − 0.03; P = 0.02), and significantly increased insulin sensitivity (β 0.008; 95% CI 0.001, 0.01; P = 0.02) and HDL-cholesterol levels (β 2.52 mg/dL; 95% CI 0.04, 5.00; P = 0.04) compared with the placebo. Moreover, probiotic supplementation led to a significant reduction in serum high sensitivity C-reactive protein (β − 0.88 mg/L; 95% CI − 1.39, − 0.38; P = 0.001), and a significant elevation in total antioxidant capacity (β 108.44 mmol/L; 95% CI 47.61, 169.27; P = 0.001) and total glutathione levels (β 45.15 µmol/L; 95% CI 5.82, 84.47; P = 0.02) compared with the placebo. Probiotic supplementation did not affect other metabolic profiles.ConclusionsOverall, we found that probiotic supplementation for 12 weeks had beneficial effects on glycemic control, HDL-cholesterol, total-/HDL-cholesterol ratio, biomarkers of inflammation and oxidative stress in diabetic patients with CHD.Trial registration Clinical trial registration number http://www.irct.ir: IRCT2017082733941N5

Probiotics have beneficial metabolic effects in patients with type 2 diabetes mellitus: a meta-analysis of randomized clinical trials

“…thermophilus B. lactis L. acidophilus Not known Not known 300 × (3,7 × 10 6 CFU) 300 × (3,7 × 10 6 CFU) 8 BW, BMI, CRP, HbA1c, FPG Moroti et al 40 Brazil 20 T2DM (TC: > 200 mg/dL, TG: > 150 mg/dL, FPG: > 110 mg/dL) L. acidophilus B. bifidum 200 × (1 × 10 8 CFU) 200 × (1 × 10 8 CFU) 4,3 TC, TG, HDL-C, FPG Ostadrahimi et al 41 Iran 60 T2DM (for: < 20 years, FPG: > 125 mg/dL) Strep. thermophiles L. casei L. acidophilus B. lactis Not known 1,200 × (15 × 10 6 CFU) 1,200 × (25 × 10 6 CFU) 1,200 × (8 × 10 6 CFU) 8 BW, TC, TG, LDL-C, HDL-C, HbA1c, FPG Raygan et al 42 Iran 54 T2DM w/ 2- or 3-vessel CHD L. acidophilus L. reuteri L. fermentum B. bifidum 2 × 10 9 CFU/g 2 × 10 9 CFU/g 2 × 10 9 CFU/g 2 × 10 9 CFU/g 12 BW, BMI, TC, TG, LDL-C, HDL-C, CRP, FPG, Insulin, SBP, DBP Raygan et al 43 Iran 60 T2DM w/ 2- or 3-vessel CHD L. acidophilus L. reuteri L. fermentum B. bifidum 2 × 10 9 CFU/g 2 × 10 9 CFU/g 2 × 10 9 CFU/g 2 × 10 9 CFU/g 12 BW, BMI, TC, TG, LDL-C, HDL-C, CRP, FPG, Insulin, SBP, DBP Raygan et al …”

Bifidobacteriumis enriched in gut microbiome of Kashmiri women with polycystic ovary syndrome

“…In contradiction with our finding, Lactobacillius, for which we found the association to depend on BMI, was found to be enriched in non-obese controls in comparison to the obese PCOS group in the same study. A randomized controlled study focusing of metabolic benefits synbiotics in PCOS reported that Lactobacillus intake resulted in lower insulin concentration, insulin resistance and higher insulin sensitivity [44] The genera Alkalibacterium and Megasphaera which we found enriched in PCOS samples are also involved in lactic acid fermentation otherwise unknown significance in human gut. Sarcina is a member of the family Clostridiaceae and species from this genus Sarcina ventriculi is an increasingly common grampositive coccus, recognized in gastric biopsies, particularly of patients with delayed gastric emptying [48] .…”

“…To date, a few observational studies on the gut microbiome of individuals with PCOS exist [20,22,28,42,43]. Bifidobacterium intake resulted in lower insulin concentration, insulin resistance and higher insulin sensitivity in patients after a 12-week intervention [44]. Relative Bifidobacterium abundance in human gut is known to be driven by lactose intolerance.…”

The Effect of Probiotics and Synbiotics on Risk Factors Associated with Cardiometabolic Diseases in Healthy People—A Systematic Review and Meta-Analysis with Meta-Regression of Randomized Controlled Trials

“…In contrary to diabetic patients, we did not find any effect of probiotic therapy on carbohydrate metabolism. A study by Raygan et al [ 102 ] which was conducted in patients with type 2 diabetes mellitus (T2DM) and coronary heart disease found that the intervention, during which the strains of Bifidobacterium bifidum , Lactobacillus casei , and Lactobacillus acidophilus were ingested for 12 weeks, significantly decreased the plasma glucose and insulin resistance. In a meta-analysis by Samah et al, [ 103 ] moderately hypoglicaemic properties (lower levels of fasting blood glucose) of microbial agents were confirmed.…”