一种多物种合生制剂对糖尿病肥胖症患者葡萄糖代谢、脂质标志物、肠道微生物群组成、肠道通透性及生活质量的影响：一项随机、双盲、安慰剂对照的初步研究
Effects of a multispecies synbiotic on glucose metabolism, lipid marker, gut microbiome composition, gut permeability, and quality of life in diabesity: a randomized, double-blind, placebo-controlled pilot study.
作者信息
Horvath Angela, Leber Bettina, Feldbacher Nicole, Tripolt Norbert, Rainer Florian, Blesl Andreas, Trieb Markus, Marsche Gunther, Sourij Harald, Stadlbauer Vanessa
机构信息
Division of Gastroenterology and Hepatology, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
Center for Biomarker Research in Medicine (CBmed), Stiftingtalstrasse 5, 8010, Graz, Austria.
出版信息
Eur J Nutr. 2020 Oct;59(7):2969-2983. doi: 10.1007/s00394-019-02135-w. Epub 2019 Nov 15.
PURPOSE
Diabesity, the combination of obesity and type 2 diabetes, is an ever-growing global health burden. Diabesity-associated dysbiosis of the intestinal microbiome has gained attention as a potential driver of disease and, therefore, a possible therapeutic target by means of pro- or prebiotic supplementation. This study tested the effects of a multispecies synbiotic (i.e. a combination of probiotics and prebiotics) on glucose metabolism, gut microbiota, gut permeability, neutrophil function and quality of life in treatment-experienced diabesity patients.
METHODS
A randomized, double-blind, placebo-controlled pilot study with 26 diabesity patients was conducted in which patients received a daily dose of a multispecies probiotic and a prebiotic (or a placebo) for 6 months.
RESULTS
There were no changes in glucose metabolism or mixed meal tolerance test responses throughout the study. The analysis of secondary outcomes revealed beneficial effects on hip circumference [- 1 (95% CI - 4; 3) vs +3 (- 1; 8) cm, synbiotics vs. placebo, respectively, p = 0.04], serum zonulin [- 0.04 (- 0.2; 0.1) vs +0.3 (- 0.05; 0.6) ng/ml, p = 0.004)] and the physical role item of the SF36 quality of life assessment [+ 5.4 (- 1.7; 12.5) vs - 5.0 (- 10.1; 0.2) points, p = 0.02] after 3 months of intervention, and lipoprotein (a) [- 2.1 (- 5.7; 1.6) vs +3.4 (- 0.9; 7.9) mg/dl, p = 0.02] after 6 months. There were no significant differences in alpha or beta diversity of the microbiome between groups or time points.
CONCLUSIONS
Glucose metabolism as the primary outcome was unchanged during the intervention with a multispecies synbiotic in patients with diabesity. Nevertheless, synbiotics improved some symptoms and biomarkers of type 2 diabetes and aspects of quality of life suggesting a potential role as adjuvant tool in the management of diabesity.
目的
糖尿病肥胖症，即肥胖与2型糖尿病并存，是一个日益加重的全球健康负担。肠道微生物群的糖尿病肥胖症相关生态失调作为疾病的潜在驱动因素已受到关注，因此，通过补充益生菌或益生元可能成为一个治疗靶点。本研究测试了一种多菌种合生元（即益生菌和益生元的组合）对有治疗经验的糖尿病肥胖症患者的葡萄糖代谢、肠道微生物群、肠道通透性、中性粒细胞功能和生活质量的影响。
方法
对26名糖尿病肥胖症患者进行了一项随机、双盲、安慰剂对照的试点研究，患者每日服用一剂多菌种益生菌和益生元（或安慰剂），持续6个月。
结果
在整个研究过程中，葡萄糖代谢或混合餐耐量试验反应没有变化。对次要结果的分析显示，干预3个月后，对臀围[分别为-1（95%CI -4；3）与+3（-1；8）厘米，合生元组与安慰剂组，p = 0.04]、血清连蛋白[-0.04（-0.2；0.1）与+0.3（-0.05；0.6）纳克/毫升，p = 0.004]以及SF36生活质量评估的身体功能项目[+5.4（-1.7；12.5）与-5.0（-10.1；0.2）分，p = 0.02]有有益影响，干预6个月后对脂蛋白（a）[-2.1（-5.7；1.6）与+3.4（-0.9；7.9）毫克/分升，p = 0.02]有有益影响。两组之间或不同时间点的微生物群α或β多样性没有显著差异。
结论
在糖尿病肥胖症患者中，以葡萄糖代谢作为主要结果，在使用多菌种合生元干预期间没有变化。然而，合生元改善了2型糖尿病的一些症状和生物标志物以及生活质量方面，表明其在糖尿病肥胖症管理中作为辅助工具的潜在作用。
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