Li Caifeng, Li Xin, Han Hongqiu, Cui Hailong, Peng Min, Wang Guolin, Wang Zhiqiang
aIntensive Care Unit bDepartment of Cardiothoracic Surgery cDepartment of General Surgery, Tianjin Medical University General Hospital, Tianjin, China.
Medicine (Baltimore). 2016 Jun;95(26):e4088. doi: 10.1097/MD.0000000000004088.
Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disease which is imposing heavy burden on global health and economy. Recent studies indicate gut microbiota play important role on the pathogenesis and metabolic disturbance of T2DM. As an effective mean of regulating gut microbiota, probiotics are live micro-organisms that are believed to provide a specific health benefit on the host. Whether probiotic supplementation could improve metabolic profiles by modifying gut microbiota in T2DM or not is still in controversy.The aim of the study is to assess the effect of probiotic supplementation on metabolic profiles in T2DM.We searched PubMed, EMBASE, and Cochrane Library up to 12 April 2016. Two review authors independently assessed study eligibility, extracted data, and evaluated risk of bias of included studies. Data were pooled by using the random-effect model and expressed as standardized mean difference (SMD) with 95% confidence interval (CI). Heterogeneity was assessed and quantified (I).A total of 12 randomized controlled trials (RCTs) were included. Lipid profiles (n = 508) and fasting blood glucose (FBG) (n = 520) were reported in 9 trials; the homeostasis model of assessment for insulin resistance index (HOMA-IR) (n = 368) and glycosylated hemoglobin (HbA1c) (n = 380) were reported in 6 trials. Probiotics could alleviate FBG (SMD -0.61 mmol/L, 95% CI [-0.92, -0.30], P = 0.0001). Probiotics could increase high-density lipoprotein-cholesterol (HDL-C) (SMD 0.42 mmol/L, 95% CI [0.08, 0.76], P = 0.01). There were no significant differences in low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), HbA1c and HOMA-IR between the treatment group and the control group.Probiotics may improve glycemic control and lipid metabolism in T2DM. Application of probiotic agents might become a new method for glucose management in T2DM.
2型糖尿病（T2DM）是一种常见的代谢性疾病，给全球健康和经济带来了沉重负担。最近的研究表明，肠道微生物群在T2DM的发病机制和代谢紊乱中起重要作用。作为调节肠道微生物群的一种有效手段，益生菌是活的微生物，被认为能给宿主带来特定的健康益处。补充益生菌是否能通过改变T2DM患者的肠道微生物群来改善代谢状况仍存在争议。本研究的目的是评估补充益生菌对T2DM患者代谢状况的影响。我们检索了截至2016年4月12日的PubMed、EMBASE和Cochrane图书馆。两位综述作者独立评估研究的合格性、提取数据并评估纳入研究的偏倚风险。采用随机效应模型汇总数据，并以标准化均数差（SMD）和95%置信区间（CI）表示。对异质性进行了评估和量化（I）。共纳入12项随机对照试验（RCT）。9项试验报告了血脂谱（n = 508）和空腹血糖（FBG）（n = 520）；6项试验报告了胰岛素抵抗指数稳态模型评估（HOMA-IR）（n = 368）和糖化血红蛋白（HbA1c）（n = 380）。益生菌可降低FBG（SMD -0.61 mmol/L，95% CI [-0.92, -0.30]，P = 0.0001）。益生菌可升高高密度脂蛋白胆固醇（HDL-C）（SMD 0.42 mmol/L，95% CI [0.08, 0.76]，P = 0.01）。治疗组和对照组在低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、甘油三酯（TG）、HbA1c和HOMA-IR方面无显著差异。益生菌可能改善T2DM患者的血糖控制和脂质代谢。应用益生菌制剂可能成为T2DM患者血糖管理的一种新方法。
