Huang Jing, Liu Chenchen, Yang Ye, Kang Dongyu, Xiao Jingmei, Long Yujun, Lang Bing, Peng Xingjie, Wang Weiyan, Wang Xiaoyi, Liu Fangkun, Zhao Jingping, Shi Zhe, Yuan Ti-Fei, Wu Renrong
Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China.
Department of Neurosurgery, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China.
Transl Psychiatry. 2022 May 4;12(1):185. doi: 10.1038/s41398-022-01958-2.
Probiotics plus dietary fiber has demonstrated efficacy in improving metabolic abnormalities. However, the efficacy of probiotics and dietary fiber as well as their association with microbiota in attenuating antipsychotic-induced weight gain and metabolic disturbance remains poorly understood. Here we analyzed results from the double-blind, randomized, placebo-controlled study to compare and evaluate the effects of probiotics, dietary fiber, and their combination for antipsychotic-induced weight gain in patients with a severe mental disorder. We found that probiotics plus dietary fiber was significantly superior to probiotics alone, dietary fiber only, and the placebo for weight, BMI, and total cholesterol reduction; insulin resistance was worse in the placebo group, with significant increases during the 12-week treatment; probiotics plus dietary fiber significantly reduced weight and prevented further deterioration of metabolic disturbances; and probiotics or dietary fiber alone can prevent further weight gain. We further performed 16 S ribosomal RNA sequencing revealed an increased abundance of microbiota after probiotics plus dietary fiber treatment. Moreover, logistic regression analyses revealed that the higher richness of microbiota was associated with favorable weight loss. These findings suggested that probiotics and dietary fiber co-administration were safe and effective interventions to reduce weight gain in patients treated with antipsychotic medications.
益生菌加膳食纤维已被证明在改善代谢异常方面具有功效。然而，益生菌和膳食纤维在减轻抗精神病药物引起的体重增加和代谢紊乱方面的功效以及它们与微生物群的关联仍知之甚少。在此，我们分析了双盲、随机、安慰剂对照研究的结果，以比较和评估益生菌、膳食纤维及其组合对重度精神障碍患者抗精神病药物引起的体重增加的影响。我们发现，益生菌加膳食纤维在减轻体重、降低体重指数（BMI）和总胆固醇方面显著优于单独使用益生菌、仅使用膳食纤维以及安慰剂；安慰剂组的胰岛素抵抗更严重，在12周治疗期间显著增加；益生菌加膳食纤维显著减轻体重并防止代谢紊乱进一步恶化；单独使用益生菌或膳食纤维可防止体重进一步增加。我们进一步进行了16S核糖体RNA测序，结果显示益生菌加膳食纤维治疗后微生物群丰度增加。此外，逻辑回归分析表明，微生物群丰富度越高与有利的体重减轻相关。这些发现表明，益生菌和膳食纤维联合使用是减轻接受抗精神病药物治疗患者体重增加的安全有效干预措施。
