Mobini Reza, Tremaroli Valentina, Ståhlman Marcus, Karlsson Fredrik, Levin Max, Ljungberg Maria, Sohlin Maja, Bertéus Forslund Heléne, Perkins Rosie, Bäckhed Fredrik, Jansson Per-Anders
Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden.
Diabetes Obes Metab. 2017 Apr;19(4):579-589. doi: 10.1111/dom.12861. Epub 2017 Feb 7.
To investigate the metabolic effects of 12-week oral supplementation with Lactobacillus reuteri DSM 17938 in patients with type 2 diabetes on insulin therapy.
In a double-blind trial, we randomized 46 people with type 2 diabetes to placebo or a low (10 CFU/d) or high dose (10 CFU/d) of L. reuteri DSM 17938 for 12 weeks. The primary endpoint was the effect of supplementation on glycated haemoglobin (HbA1c). Secondary endpoints were insulin sensitivity (assessed by glucose clamp), liver fat content, body composition, body fat distribution, faecal microbiota composition and serum bile acids.
Supplementation with L. reuteri DSM 17938 for 12 weeks did not affect HbA1c, liver steatosis, adiposity or microbiota composition. Participants who received the highest dose of L. reuteri exhibited increases in insulin sensitivity index (ISI) and serum levels of the secondary bile acid deoxycholic acid (DCA) compared with baseline, but these differences were not significant in the between-group analyses. Post hoc analysis showed that participants who responded with increased ISI after L. reuteri supplementation had higher microbial diversity at baseline, and increased serum levels of DCA after supplementation. In addition, increases in DCA levels correlated with improvement in insulin sensitivity in the probiotic recipients.
Intake of L. reuteri DSM 17938 for 12 weeks did not affect HbA1c in people with type 2 diabetes on insulin therapy; however, L. reuteri improved insulin sensitivity in a subset of participants and we propose that high diversity of the gut microbiota at baseline may be important.
研究口服罗伊氏乳杆菌DSM 17938 12周对接受胰岛素治疗的2型糖尿病患者的代谢影响。
在一项双盲试验中，我们将46例2型糖尿病患者随机分为安慰剂组、低剂量（10⁹CFU/d）或高剂量（10¹⁰CFU/d）罗伊氏乳杆菌DSM 17938组，为期12周。主要终点是补充剂对糖化血红蛋白（HbA1c）的影响。次要终点包括胰岛素敏感性（通过葡萄糖钳夹评估）、肝脏脂肪含量、身体成分、体脂分布、粪便微生物群组成和血清胆汁酸。
补充罗伊氏乳杆菌DSM 17938 12周对HbA1c、肝脏脂肪变性、肥胖或微生物群组成没有影响。与基线相比，接受最高剂量罗伊氏乳杆菌的参与者胰岛素敏感性指数（ISI）和次级胆汁酸脱氧胆酸（DCA）的血清水平有所升高，但在组间分析中这些差异不显著。事后分析表明，罗伊氏乳杆菌补充后ISI升高的参与者在基线时具有更高的微生物多样性，补充后血清DCA水平升高。此外，益生菌接受者中DCA水平的升高与胰岛素敏感性的改善相关。
对于接受胰岛素治疗的2型糖尿病患者，口服罗伊氏乳杆菌DSM 17938 12周对HbA1c没有影响；然而，罗伊氏乳杆菌在一部分参与者中改善了胰岛素敏感性，我们认为基线时肠道微生物群的高度多样性可能很重要。
