Abstract

Background: Although many studies have shown that consumption of probiotics is relevant to diabetes, the effects of probiotics improves clinical outcomes in type 2 diabetes have yielded conflicting results. The aim of this meta-analysis was conducted to assess the effects of probiotics supplementation on glycemic, blood lipids, pressure and inflammatory control in type 2 diabetes.

Methods: PubMed, Web of science, Embase and the Cochrane Library databases were searched for relevant studies from February 2015 up to Janurary 2020, with no language restrictions. The pooled results were calculated with the use of a random-effects model to assess the impact of supplemental probiotics on glycemic, blood lipids, pressure and inflammatory control in type 2 diabetes. Additionally, subgroup analysis was conducted based on patients age, body mass index (BMI), country and duration of the probiotics supplement, respectively.

Results: 13 studies were included in this meta-analysis, involving a total of 818 participants in 8 countries. Overall, compared with control groups, the subjects who received multiple species of probiotics had a statistically significant reduction in fasting blood sugar (FBS), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglycerides (TG), systolic blood pressure (SBP), diastolic blood pressure (DBP) and tumor necrosis factor (TNF) -α [standardized mean difference (SMD): −0.89 mg/Dl, 95% CI: −1.66, −0.12 mg/dL; SMD: −0.43, 95% CI: −0.63, −0.23; SMD: −0.19 mg/dL, 95% CI: −0.36, −0.01 mg/dL; SMD: −0.23 mg/dL, 95% CI: −0.40, −0.05 mg/dL; SMD: −5.61 mmHg, 95% CI: −9.78, −1.45 mmHg; SMD: −3.41 mmHg, 95% CI: −6.12, −0.69 mmHg; and SMD: 6.92 pg/ml, 95% CI: 5.95, 7.89 pg/ml, respectively]. However, the subjects who received single-species of probiotic or probiotic with co-supplements in food only changed FBS, HOMA-IR, DBP and TG levels. Moreover, subgroup analyses revealed that the effects of probiotics supplementation on FBS, HMOA-IR, SBP and DBP are significantly influenced by patients age, body mass index (BMI), country and duration of the probiotics supplement.

Conclusion: Our analysis revealed that glycemic, lipids, blood pressure and inflammation indicators are significantly improved by probiotic supplementation, particularly the subjects who ages ≤ 55, baseline BMI< 30 kg/m², duration of intervention more than 8 weeks, and received multiple species probiotic.

摘要

背景：尽管许多研究表明食用益生菌与糖尿病有关，但益生菌的作用改善了2型糖尿病的临床结局，但产生了相互矛盾的结果。进行这项荟萃分析的目的是评估补充益生菌对2型糖尿病患者血糖，血脂，压力和炎症控制的影响。

方法：从2015年2月至2020年1月，在PubMed，Web of Science，Embase和Cochrane图书馆数据库中进行相关研究，没有语言限制。使用随机效应模型计算汇总结果，以评估补充益生菌对2型糖尿病患者的血糖，血脂，压力和炎症控制的影响。此外，分别根据患者年龄，体重指数（BMI），补充益生菌的国家和时间进行亚组分析。

结果：这项荟萃分析包括13项研究，涉及8个国家的818名参与者。总体而言，与对照组相比，接受多种益生菌的受试者的空腹血糖（FBS），稳态模型评估的胰岛素抵抗（HOMA-IR），总胆固醇（TC），甘油三酸酯（TG）均有统计学意义的降低，收缩压（SBP），舒张压（DBP）和肿瘤坏死因子（TNF）-α[标准化平均差异（SMD）：-0.89 mg / Dl，95％CI：-1.66，-0.12 mg / dL；SMD：-0.43，95％CI：-0.63，-0.23； SMD：-0.43，95％CI：-0.63，-0.23。SMD：-0.19 mg / dL，95％CI：-0.36，-0.01 mg / dL；SMD：-0.23 mg / dL，95％CI：-0.40，-0.05 mg / dL；SMD：−5.61 mmHg，95％CI：−9.78，-1.45 mmHg；SMD：−3.41 mmHg，95％CI：−6.12，−0.69 mmHg；和SMD：6.92 pg / ml，95％CI：5.95，7.89 pg / ml]。然而，接受单一种类的益生菌或益生菌与食物共同补充的受试者只会改变FBS，HOMA-IR，DBP和TG水平。此外，亚组分析显示，益生菌补充剂对FBS，HMOA-IR，SBP和DBP的影响受患者年龄，体重指数（BMI），国家和益生菌补充剂持续时间的影响很大。

结论：我们的分析表明，益生菌补充剂可以显着改善血糖，血脂，血压和炎症指标，尤其是年龄≤55岁，基线BMI <30 kg / m ²，干预时间超过8周并接受多次干预的受试者种益生菌。