Background

This study performed a systematic and meta-analysis of randomized controlled trials (RCTs) to explore the efficacy of probiotic- and symbiotic-based supplements in the treatment of gestational diabetes mellitus (GDM).

Methods

We performed a meta-analysis to evaluate the efficacy of probiotics/synbiotics in GDM treatment, following a systematic search in Web of Science, PubMed, Cochrane Library, and EBSCO databases for articles published up to July 2020.

Results

In total, 12 RCTs comprising 894 participants, were analyzed. Compared to the placebo, patients administered with probiotic and synbiotic supplements benefited more with regards to glucose and lipid metabolism as well as anti-inflammation and antioxidant capacity including insulin of change (WMD: 3.57, 95%CI: −5.26, −1.88), very-low-density lipoprotein (VLDL) (WMD: −5.03, 95%CI: −8.26, −1.79), nitric oxide (NO) at the end of trial (WMD: 2.31, 95%CI: 0.91, 3.70), total antioxidant capacity (TAC) at the end of trial (SMD: 0.74, 95%CI: 0.21, 1.27), high-sensitivity C-reactive protein (hsCRP) at the end of trial (SMD: −1.23, 95%CI: −1.97, −0.49). Besides, probiotic and synbiotic supplements improved outcomes on fetal hyperbilirubinemia risk (RR: 0.26, 95%CI: 0.12, 0.55), fetal macrosomia risk (RR: 0.47, 95%CI: 0.27, 0.83) and newborn weight (SMD: −0.29, 95%CI: −0.50, −0.09).

Conclusions

Findings from this work demonstrate that probiotic/symbiotic-based interventions improve glucose and lipid metabolism, anti-inflammatory and antioxidant ability in diet-controlled GDM patients, and exert beneficial outcomes on fetal hyperbilirubinemia, fetal macrosomia, and newborn weight.

中文翻译：

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益生菌和合生元在治疗妊娠期糖尿病方面显示出临床疗效：荟萃分析

背景

本研究对随机对照试验 (RCT) 进行了系统的荟萃分析，以探索基于益生菌和共生菌的补充剂在治疗妊娠期糖尿病 (GDM) 中的功效。

方法

在对 Web of Science、PubMed、Cochrane 图书馆和 EBSCO 数据库中截至 2020 年 7 月发表的文章进行系统搜索后，我们进行了一项荟萃分析，以评估益生菌/合生元在 GDM 治疗中的功效。

结果

总共分析了 12 项 RCT，包括 894 名参与者。与安慰剂相比，服用益生菌和合生元补充剂的患者在葡萄糖和脂质代谢以及抗炎和抗氧化能力（包括变化的胰岛素）方面受益更多（WMD：3.57，95%CI：-5.26，-1.88），极低密度脂蛋白 (VLDL) (WMD: -5.03, 95%CI: -8.26, -1.79)，试验结束时的一氧化氮 (NO) (WMD: 2.31, 95%CI: 0.91, 3.70)，试验结束时的总抗氧化能力 (TAC) (SMD: 0.74, 95%CI: 0.21, 1.27)，试验结束时的高敏 C 反应蛋白 (hsCRP) (SMD: -1.23, 95%CI: -1.97，-0.49）。此外，益生菌和合生元补充剂改善了胎儿高胆红素血症风险 (RR: 0.26, 95%CI: 0.12, 0.55)、巨大儿风险 (RR: 0.47, 95%CI: 0.27, 0.83) 和新生儿体重 (SMD: -0 .

结论

这项工作的结果表明，基于益生菌/共生菌的干预措施可改善饮食控制的 GDM 患者的葡萄糖和脂质代谢、抗炎和抗氧化能力，并对胎儿高胆红素血症、巨大儿和新生儿体重产生有益的结果。