Khalili Leila, Alipour Beitullah, Asghari Jafar-Abadi Mohammad, Faraji Ismail, Hassanalilou Tohid, Mesgari Abbasi Mehran, Vaghef-Mehrabany Elnaz, Alizadeh Sani Mahmood
Department of Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Community Nutrition, Faculty of nutrition and food sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
Iran Biomed J. 2019 Jan;23(1):68-77. doi: 10.29252/.23.1.68. Epub 2018 May 27.
Type 2 diabetes mellitus (T2DM) is related to the gut microbiota with numerous molecular mechanisms. Modulating the gut microbiota by probiotics could be effective in management of T2DM. The aim of the present trial was to evaluate the effect of Lactobacillus casei on glycemic control and serum sirtuin1 (SIRT1) and fetuin-A in patients with T2DM.
Forty patients with T2DM (n = 20 for each group) were divided into intervention (probiotic) and placebo groups. The intervention group received a daily capsule containing 108 cfu of L. casei for eight weeks. The patients in placebo group took capsules containing maltodextrin for the same time duration. Anthropometric measurements, dietary intake questionnaires, and blood samples were collected, and the patients were assessed by an endocrinologist at the beginning and at the end of the trial.
Fasting blood sugar, insulin concentration, and insulin resistance significantly decreased in probiotic group compared with placebo group (-28.32 [-50.23 to -6.41], 0.013; -3.12 [-5.90 to -0.35], 0.028; -32.31 [-55.09 to -9.54], 0.007, respectively). Moreover, HbA1c reduced after intervention, but the reduction was not significant (-0.45 [-0.96 to 0.05], 0.077). In comparison with placebo, the L. casei supplementation significantly increased SIRT1 and decreased fetuin-A levels at the end of the trial (0.52 [0.026 to 1.02], 0.040; -17.56 [-32.54 to -2.58], 0.023, respectively).
L. casei supplementation affected SIRT1 and fetuin-A levels in a way that improved glycemic response in subjects with T2DM. Affecting the SIRT1 and fetuin-A levels introduces a new known mechanism of probiotic action in diabetes management.
2型糖尿病（T2DM）与肠道微生物群通过多种分子机制相关。通过益生菌调节肠道微生物群可能对T2DM的管理有效。本试验的目的是评估干酪乳杆菌对T2DM患者血糖控制以及血清沉默信息调节因子1（SIRT1）和胎球蛋白-A的影响。
40例T2DM患者（每组n = 20）被分为干预组（益生菌组）和安慰剂组。干预组每天服用一粒含有10⁸cfu干酪乳杆菌的胶囊，持续8周。安慰剂组患者在相同时间段内服用含有麦芽糊精的胶囊。收集人体测量数据、饮食摄入问卷和血样，并在试验开始和结束时由内分泌科医生对患者进行评估。
与安慰剂组相比，益生菌组的空腹血糖、胰岛素浓度和胰岛素抵抗显著降低（分别为-28.32 [-50.23至-6.41]，P = 0.013；-3.12 [-5.90至-0.35]，P = 0.028；-32.31 [-55.09至-9.54]，P = 0.007）。此外，干预后糖化血红蛋白降低，但降低不显著（-0.45 [-0.96至0.05]，P = 0.077）。与安慰剂相比，试验结束时补充干酪乳杆菌显著提高了SIRT1水平并降低了胎球蛋白-A水平（分别为0.52 [0.026至1.02]，P = 0.040；-17.56 [-32.54至-2.58]，P = 0.023）。
补充干酪乳杆菌以改善T2DM患者血糖反应的方式影响了SIRT1和胎球蛋白-A水平。影响SIRT1和胎球蛋白-A水平为益生菌在糖尿病管理中的作用引入了一种新的已知机制。
