Faculty of Medicine, Alexandria University, Egypt; International Medical Students' Research Association IMedRA, Egypt.
Faculty of Medicine, Al-Azhar University, Damietta, Egypt; International Medical Students' Research Association IMedRA, Egypt.
Clin Nutr ESPEN. 2020 Dec;40:57-67. doi: 10.1016/j.clnesp.2020.06.019. Epub 2020 Sep 19.
Diabetic nephropathy (DN) is one of the diabetes mellitus complications, which develops in approximately one-third of diabetic patients. Probiotics are microorganisms such as Lactobacillus and Bifidobacterium which have some benefits with gastrointestinal disorders and diabetic patients.
We aim to assess the efficacy of probiotic supplementation in patients with diabetic nephropathy (DN).
We searched PubMed, Scopus, Web of Science, and Cochrane on 20 august 2019 and updated the search on 26 April 2020 using relevant keywords. Studies were screened for eligibility. We extracted the data from the relevant articles and then these data were pooled as mean difference (MD) with a 95% confidence interval (CI), using Review Manager software (ver. 3.5).
Pooled data from four trials compared probiotics with a placebo showed a significant reduction in insulin (MD = -1.99, 95% CI [-3.99, 0.01]) and Homeostatic Model Assessment for Insulin Resistance (MD = -3.87, 95% CI [-7.51, -0.22]), High-sensitivity C-reactive protein (MD = -1.55, 95% CI [-2.19, -0.92]), malondialdehyde (MD = -0.77, 95% CI [-0.96, -0.58]), sodium (MD = -0.93, 95% CI [-1.87, -0.01]), but the total antioxidant capacity was significantly increased (MD = 62.29, 95% CI [18.34, 106.24]), while no significant effect on other lipid profiles, oxidative stress biomarkers or kidney function parameters like creatinine and glomerular filtration rate. Two trials showed that probiotic soy is better than conventional soy in terms of kidney function and lipid profiles.
Probiotics supplementation decreases serum insulin and insulin resistance, but it has no beneficial effect regarding kidney function, body-weight, and lipid profiles, with a moderate positive effect regarding some oxidative stress biomarkers. Also, probiotic soy protein may improve kidney function and lipid profiles. Further studies are needed to confirm our findings and to assess the long-term effect.
糖尿病肾病（DN）是糖尿病的并发症之一，约有三分之一的糖尿病患者会发展为糖尿病肾病。益生菌是一种微生物，如乳杆菌和双歧杆菌，对胃肠道疾病和糖尿病患者有一定益处。
评估益生菌补充剂对糖尿病肾病（DN）患者的疗效。
我们于 2019 年 8 月 20 日在 PubMed、Scopus、Web of Science 和 Cochrane 上进行了检索，并于 2020 年 4 月 26 日使用相关关键词进行了更新检索。我们筛选了研究的合格性。我们从相关文章中提取数据，然后使用 Review Manager 软件（版本 3.5）将这些数据汇总为均数差（MD）和 95%置信区间（CI）。
四项试验的汇总数据比较了益生菌与安慰剂，结果显示益生菌可显著降低胰岛素（MD=-1.99，95%CI[-3.99，0.01]）和胰岛素抵抗稳态模型评估（MD=-3.87，95%CI[-7.51，-0.22]）、高敏 C 反应蛋白（MD=-1.55，95%CI[-2.19，-0.92]）、丙二醛（MD=-0.77，95%CI[-0.96，-0.58]）、钠（MD=-0.93，95%CI[-1.87，-0.01]），但总抗氧化能力显著增加（MD=62.29，95%CI[18.34，106.24]），而对其他血脂谱、氧化应激生物标志物或肾功能参数如肌酐和肾小球滤过率无显著影响。两项试验表明，益生菌大豆在改善肾功能和血脂谱方面优于常规大豆。
益生菌补充剂可降低血清胰岛素和胰岛素抵抗，但对肾功能、体重和血脂谱无有益作用，对一些氧化应激生物标志物有适度的积极作用。此外，益生菌大豆蛋白可能改善肾功能和血脂谱。需要进一步的研究来证实我们的发现，并评估长期效果。
