Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Department of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Cardiovasc Res. 2023 May 2;119(4):933-956. doi: 10.1093/cvr/cvac128.
Although the available evidence emphasizes the beneficial effects of probiotics in normalizing various cardiometabolic markers, there is still substantial uncertainty in this regard. Thus, we set out to determine the effect sizes of probiotics on blood lipid parameters more coherently. A systematic literature search of the Medline (PubMed) and Scopus databases was conducted from inception to 12 February 2021, applying both MeSH terms and free text terms to find the relevant randomized controlled trials (RCTs). The meta-analysis was conducted based on a random-effect model to calculate the mean effect sizes demonstrated as weighted mean differences (WMDs) and the 95% confidence intervals (95% CIs). To explore the heterogeneity, the Cochrane χ2 test, and analysis of Galbraith plots were performed. Meta-analysis of data from 40 RCTs (n = 2795) indicated a significant decrease in serum/plasma triglyceride [WMD (95% CI) = -12.26 (-17.11 to -7.41) mg/dL; P-value <0.001; I2 (%) = 29.9; P heterogeneity = 0.034], total cholesterol (with high heterogeneity) (WMD (95% CI) = -8.43 (-11.90 to -4.95) mg/dL; P-value <0.001; I2 (%) = 56.8; P heterogeneity < 0.001), LDL-C [WMD (95% CI) = -5.08 (-7.61, -2.56) mg/dL; P-value <0.001; I2 (%) = 42.7; P heterogeneity = 0.002], and HDL-C (with high heterogeneity) (WMD (95% CI) = 1.14 (0.23, 2.05) mg/dL; P-value = 0.014; I2 (%) = 59.8; P heterogeneity < 0.001) following receiving probiotic/synbiotic supplements. Collectively, the current preliminary evidence supports the effectiveness of probiotics/synbiotics in improving dyslipidaemia and various lipid parameters more prominently among subjects with hyperlipidaemia, diabetes, and metabolic syndrome. However, large and well conducted RCTs are required to provide further convincing support for these results.
虽然现有证据强调了益生菌在使各种心血管代谢标志物正常化方面的有益作用，但在这方面仍存在很大的不确定性。因此，我们着手更一致地确定益生菌对血脂参数的影响大小。从 2021 年 2 月 12 日开始，对 Medline（PubMed）和 Scopus 数据库进行了系统的文献检索，使用了 MeSH 术语和自由文本术语来查找相关的随机对照试验（RCT）。基于随机效应模型进行了荟萃分析，以计算作为加权均数差（WMD）和 95%置信区间（95%CI）表示的平均效应大小。为了探索异质性，进行了 Cochrane χ2检验和 Galbraith 图分析。对 40 项 RCT（n=2795）的数据进行荟萃分析表明，血清/血浆甘油三酯显著降低[WMD（95%CI）=-12.26（-17.11 至-7.41）mg/dL；P 值<0.001；I2（%）=29.9；P 异质性=0.034]，总胆固醇（高度异质性）[WMD（95%CI）=-8.43（-11.90 至-4.95）mg/dL；P 值<0.001；I2（%）=56.8；P 异质性<0.001]，LDL-C [WMD（95%CI）=-5.08（-7.61，-2.56）mg/dL；P 值<0.001；I2（%）=42.7；P 异质性=0.002]和 HDL-C（高度异质性）[WMD（95%CI）=1.14（0.23，2.05）mg/dL；P 值=0.014；I2（%）=59.8；P 异质性<0.001]，接受益生菌/合生剂补充后。总的来说，目前的初步证据支持益生菌/合生剂在改善高脂血症患者、糖尿病患者和代谢综合征患者的血脂异常和各种血脂参数方面更有效。然而，需要进行大型和精心设计的 RCT 以提供更令人信服的结果支持这些结果。
