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The Effects of Probiotics/Synbiotics on Glucose and Lipid Metabolism in Women with Gestational Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials.
Mu, J, Guo, X, Zhou, Y, Cao, G
Nutrients. 2023;15(6)
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Women with gestational diabetes mellitus (GDM) are at an increased risk of complications during pregnancy and type 2 diabetes, pancreatic cancer, and heart disease after pregnancy. There is some controversy over the research surrounding current treatments of GDM and as such new treatment strategies are being researched and developed. Amongst these is the possibility of using probiotics and synbiotics to alleviate the driving factors of GDM, however the research is inconclusive as some studies have shown a benefit whereas others have not. This meta-analysis of 11 randomised control trials (RCTs) containing 779 participants aimed to determine the effect of probiotic/synbiotics on sugar and lipid levels in the blood. The results showed that amongst 8 of the RCTs, Lactobacillus was the most researched probiotic gut bacteria, with 6 species researched. In addition, Bifidobacterium bifidum and Streptococcus thermophilus were also used as a probiotic. 3 RCTs looked at synbiotics including 5 Lactobacillus species and 3 Bifidobacterium species. Supplementation with probiotics/synbiotics significantly improved blood sugar levels, measures of insulin resistance, and total cholesterol in pregnant women with GDM. Other blood lipids such as triglycerides, high density lipoprotein, low density lipoprotein, weight at the end of the trial, and weight gain during pregnancy were unaffected by supplementation. It was concluded that probiotics/synbiotics are of benefit to women with GDM especially if they contain L. acidophilus and B. bifidum. However, there may be more research required to better inform GDM management. This study could be used by healthcare professionals to understand that the gut microbiota may have a pivotal role in GDM. More research is required before this forms part of a regular management strategy.
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is prevalent with lasting health implications for the mother and offspring. Medical therapy is the foundation of GDM management, for achieving optimal glycemic control often requires treatment with insulin or metformin. Gut dysbiosis is a feature of GDM pregnancies, therefore, dietary manipulation of the gut microbiota may offer a new avenue for management. Probiotics are a relatively new intervention, which can reduce the mother's blood sugar levels and, furthermore, adjust glucose and lipid metabolism in both mother and offspring. OBJECTIVE The aim of this systematic review and meta-analysis is to explore the effect of probiotics/synbiotics on glucose and lipid metabolism in women with GDM. METHODS A systematic search of the literature was conducted using the electronic databases Cochrane Library, Web of Science, PubMed, and EBOSCO, published between 1 January 2012 and 1 November 2022. A total of 11 randomized controlled clinical trials (RCTs) were analyzed. The indicators included fasting plasma glucose (FPG), fasting serum insulin (FSI), the homoeostatic model assessment for insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), total cholesterol (TC), HDL cholesterol, LDL cholesterol and triglycerides (TG), the mean weight at end of trial, and gestational weight gain (GWG). RESULTS Compared with the placebo, probiotics/synbiotics were associated with a statistically significant improvement in FPG (MD = -2.33, 95% CI = -4.27, -0.40, p = 0.02), FSI (MD = -2.47 95% CI = -3.82, -1.12, p = 0.0003), HOMA-IR (MD = -0.40, 95% CI = -0.74, -0.06, p = 0.02), and TC (MD = -6.59, 95% CI = -12.23,--0.95, p = 0.02), while other factors had no significant difference. The subgroup analysis revealed that the kind of supplement led to heterogeneity for FPG and FSI, while heterogeneity was not found for others. CONCLUSION Probiotics/synbiotics could control glucose and lipid metabolism in pregnant women with GDM. There was a significant improvement in FPG, FSI, HOMA-IR, and TC. The use of specific probiotic supplementation may be a promising prevention and therapeutic strategy for GDM. However, due to the heterogeneity among existing studies, further studies are warranted to address the limitations of existing evidence and better inform the management of GDM.
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Blood levels of circulating methionine components in Alzheimer's disease and mild cognitive impairment: A systematic review and meta-analysis.
Zhao, Y, Dong, X, Chen, B, Zhang, Y, Meng, S, Guo, F, Guo, X, Zhu, J, Wang, H, Cui, H, et al
Frontiers in aging neuroscience. 2022;14:934070
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Alzheimer’s disease (AD) is a chronic neurodegenerative disease that is characterized by progressive memory loss and cognitive deficits. Mild cognitive impairment (MCI) is a prodromal form of AD that is characterised by neurocognitive dysfunction. However, pathological changes associated with AD begin to occur in the brain at least 10 years before the onset of overt symptoms and clinical manifestations, making the discovery of early diagnostic methods and timely interventions important for AD management. The aim of this study was to determine the relationship between circulating methionine (Met) components and AD/MCI. This study is a systematic review and meta-analysis of thirty studies (10 case– control studies, 10 cohort studies, and 10 cross-sectional studies). Results show that: - individuals with AD compared with controls had significantly increased levels of homocysteine. - for people with MCI, there was no significant difference in blood homocysteine levels in the control group. - there were no differences in blood vitamin B12 levels between patients with AD or MCI and controls. Authors conclude that circulating Met components affect patients with AD compared to cognitively normal individuals, with patients exhibiting higher blood homocysteine levels. Additionally, high Met and S-adenosylmethionine levels are risk factors for AD, which supports the association between Met cycle components and AD/MCI.
Abstract
BACKGROUND Circulating methionine components have been reported to be associated with Alzheimer's disease (AD) and mild cognitive impairment (MCI), although outcomes are not always consistent. MATERIALS AND METHODS Database searching was conducted using PubMed, Embase, Cochrane Library, and Web of Science from inception to 26 December 2021. In this study, two reviewers independently identified eligible articles and extracted the data. We used Joanna Briggs Institute (JBI) Critical Appraisal tools to assess the overall quality of the included studies. STATA software was employed to perform meta-analysis evaluating the standardized mean difference (SMD) with its 95% confidence intervals (CIs) using random-effects models. Evidence quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. RESULTS Totally, 30 observational studies were eligible for inclusion. Compared with cognitively normal controls, patients with AD had increased homocysteine (Hcy) levels in the blood [standardized mean difference (SMD) = 0.59, 95% confidence interval [CI]: 0.36-0.82, P = 0.000], plasma (SMD = 0.39, 95% CI: 0.23-0.55, P = 0.000), and serum (SMD = 1.56, 95% CI: 0.59-2.95, P = 0.002). Patients with MCI were not significantly different from controls (SMD = 0.26, 95% CI: -0.07-0.58, P = 0.127). Patients with AD or MCI did not significantly differ from controls of blood vitamin B12 levels, AD (SMD = -0.05, 95% CI: -0.19-0.08, P = 0.440), or MCI (SMD = 0.01, 95% CI: -0.16-0.17, P = 0.94). Some cohort studies have suggested that higher Hcy, methionine, and S-adenosylmethionine levels may accelerate cognitive decline in patients with MCI or AD, and vitamin B12 deficiency is a risk factor for the disease; however, the results of other studies were inconsistent. According to the GRADE system, all these outcomes scored very low to low quality, and no high-quality evidence was found. CONCLUSION Only Hcy levels in the plasma and serum were found to be inversely related to the risk of AD. However, due to the low quality of supporting these results, high-quality studies are needed to verify these findings. SYSTEMATIC REVIEW REGISTRATION http://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022308961.
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Effect of Lactobacillus casei on lipid metabolism and intestinal microflora in patients with alcoholic liver injury.
Li, X, Liu, Y, Guo, X, Ma, Y, Zhang, H, Liang, H
European journal of clinical nutrition. 2021;75(8):1227-1236
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Alcoholic liver disease (ALD) is a series of liver diseases caused by long-term heavy drinking. Lipid metabolism disorder often occurs in people with alcoholic liver injury. Treatment is mainly a combination of alcohol abstinence, improving nutrition, treating the liver injury, and preventing or reversing the progress of liver fibrosis or promoting liver regeneration. The aim of this study was to investigate the effect of Lactobacillus casei on lipid metabolism and intestinal microflora in patients with alcoholic liver injury. This study was a randomised, double-blind, placebo-controlled trial. A total of 181 ALD patients were recruited and randomly assigned to one of the three groups; low-dose group, high-dose group and positive control group (+ there was another group of 20 healthy people which served as normal control group). Results showed disorder of lipid metabolism, intestinal flora imbalance and inflammation in patients with alcoholic liver injury. Furthermore, after supplementation of Lactobacillus casei, there was a significant increase in the amount of Lactobacillus and Bifidobacterium. Authors conclude that Lactobacillus casei supplementation can improve lipid metabolism and regulate intestinal flora disorders in patients with alcoholic liver injury.
Abstract
BACKGROUND The present study aims to investigate the effect of Lactobacillus casei on lipid metabolism and intestinal microflora in patients with alcoholic liver injury. METHODS In a double-blind randomized controlled trial, 158 recruited alcoholic liver injury patients were randomized to three treatments for 60 days: low-dose group (LP, n = 58, 100 ml of Lactobacillus casei strain Shirota (LcS)), high-dose group (HP, n = 54, 200 ml of LcS), and positive control group (PC, n = 46, 100 ml of special drinks without active Lactobacillus casei). Another group of 20 healthy people was served as normal control group (NC). RESULTS The serum levels of TG and LDLC in the HP group were significantly decreased by 26.56% and 23.83%, respectively than those in the PC group (P < 0.05). After supplementation of Lactobacillus casei, there was a significant increase in the amount of Lactobacillus and Bifidobacterium when compared with the PC group (P < 0.05). CONCLUSIONS Supplementation of Lactobacillus casei can improve lipid metabolism and regulate intestinal flora disorders in patients with alcoholic liver injury.