Effects of a 6-month multi-strain probiotics supplementation in endotoxemic, inflammatory and cardiometabolic status of T2DM patients: a randomized, double-blind, placebo-controlled trial

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Sabico, S., Al-Mashharawi, A., Al-Daghri, N.M., Wani, K., Amer, O.E., Hussain, D.S., Ansari, M.G.A., Masoud, M.S., Alokail, M.S. and McTernan, P.G. ORCID: 0000-0001-9023-0261, 2018. Effects of a 6-month multi-strain probiotics supplementation in endotoxemic, inflammatory and cardiometabolic status of T2DM patients: a randomized, double-blind, placebo-controlled trial. Clinical Nutrition. ISSN 0261-5614

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Official URL: http://doi.org/10.1016/j.clnu.2018.08.009

Abstract

Objective
The aim of this trial was to characterize the beneficial effects of probiotics on decreasing endotoxin levels and other cardiometabolic parameters in Arab patients with type 2 diabetes mellitus (T2DM).
Methods
Saudi adults with naïve T2DM (n=61; 12 males and 18 females) were randomly allocated to receive twice daily placebo or 2.5×109cfu/gram of Ecologic®Barrier (multi-strain probiotics; 14 males and 17 females) in a double-blind manner over a 6 month period, respectively. Anthropometrics were measured and fasting blood samples were collected to analyze endotoxin, glycemic parameters [glucose, insulin, c-peptide and homeostasis model assessment for insulin resistance (HOMA-IR)], lipids [triglycerides, total cholesterol, low and high-density lipoprotein (LDL and HDL, respectively) cholesterol and total/HDL-cholesterol ratio], inflammatory markers [tumor-necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP)] and adipocytokines [leptin, adiponectin and resistin] at baseline and after 3 and 6 months of intervention.
Results
Multi-strain probiotics supplementation for 6 months caused a significant decrease in circulating levels of endotoxin by almost 70% over 6 months, as well as glucose (38%), insulin (38%), HOMA-IR (64%), triglycerides (48%), total cholesterol (19%), total/HDL-cholesterol ratio (19%), TNF-α (67%), IL-6 (77%), CRP (53%), resistin (53%), and a significant increase in adiponectin (72%) as compared with baseline. Only HOMA-IR had a clinically significant reduction (-3.4, 64.2%) in the probiotics group as compared to placebo group at all time points. No other clinically significant changes were observed between the probiotic or placebo group at 3 and 6 months in other markers.
Conclusion
Multi-strain probiotic supplementation over 6 months as a monotherapy significantly decreased HOMA-IR in T2DM patients, with the probiotic treatment group highlighting reduced inflammation and improved cardiometabolic profile. As such, multi-strain probiotics is a promising adjuvant anti-diabetes therapy.

Item Type:

Journal article

Publication Title:

Clinical Nutrition

Creators:

Sabico, S., Al-Mashharawi, A., Al-Daghri, N.M., Wani, K., Amer, O.E., Hussain, D.S., Ansari, M.G.A., Masoud, M.S., Alokail, M.S. and McTernan, P.G.

Publisher:

Elsevier for the European Society for Clinical Nutrition and Metabolism (ESPEN)

Date:

17 August 2018

ISSN:

0261-5614