Department of Affective and Psychotic Disorders, Medical University of Lodz, 8/10 Czechoslowacka St., 92-216 Lodz, Poland.
Department of Biostatistics and Translational Medicine, Medical University of Lodz, 15 Mazowiecka St., 92-215 Lodz, Poland.
Clin Nutr ESPEN. 2024 Oct;63:604-614. doi: 10.1016/j.clnesp.2024.07.1024. Epub 2024 Jul 30.
BACKGROUND & AIMS: There is a need to identify new treatment options for depression with its comorbidities. Depression often coexists with liver steatosis and the two may share a pathophysiological overlap, including inflammation and microbiota changes. Probiotics might represent a safe option as an adjunctive therapy in patients with depression and possible liver steatosis. The paper presents the secondary analysis of a clinical trial of the effect of probiotic supplementation on the levels of non-invasive markers of liver steatosis and fibrosis in adult patients with depressive disorders.
The research had a two-arm, parallel-group, prospective, randomized, double-blind, controlled design on probiotics in depression. 116 participants received a probiotic preparation containing Lactobacillus helveticus Rosell®-52 and Bifidobacterium longum Rosell®-175 over 60 days. Here, data from 92 subjects was analyzed. The following were assessed: alanine aminotransferase (ALT), alanine aminotransferase/aspartate aminotransferase (ALT/AST) ratio, Hepatic Steatosis Index, Framingham Steatosis Index, as well as non-invasive biomarkers of liver fibrosis (AST to Platelet Ratio Index, Fibosis-4 Index), or baseline socio-demographic, clinical, and laboratory parameters.
The probiotics did not influence liver steatosis and fibrosis parameters compared with placebo (p = 0.940 for HSI). However, the subgroup analysis revealed significant differences in liver-related parameters when stratified by the main diagnosis group (better improvement in steatosis indices after probiotics in depressive episode than mixed depression and anxiety disorder patients) or psychotropic medications use (better improvement in ALT-based indices after probiotics in antidepressant-treated subjects than those non-antidepressant-treated). The interplay between probiotics, medications, clinical and metabolic profiles of depression, and the changes in liver-related parameters has been discussed.
Multiple factors may modulate the postulated hepatoprotective properties of probiotics efficacy in patients with depression. Further studies with larger sample sizes, different probiotic strains, and longer intervention period are necessary to assess the real significance of probiotics for liver health in this population.
NCT04756544.
需要寻找新的治疗方法来治疗伴有合并症的抑郁症。抑郁症常与肝脂肪变性并存，两者可能具有重叠的病理生理学特征，包括炎症和微生物群改变。益生菌可能是治疗抑郁症合并肝脂肪变性患者的一种安全的辅助治疗选择。本文报告了一项益生菌对成年抑郁障碍患者非侵入性肝脂肪变性和纤维化标志物水平影响的临床试验的二次分析结果。
这是一项益生菌治疗抑郁症的两臂、平行组、前瞻性、随机、双盲、对照临床试验。116 名参与者接受了含有乳杆菌 helveticus Rosell®-52 和长双歧杆菌 Rosell®-175 的益生菌制剂治疗，为期 60 天。本研究分析了 92 名受试者的数据。评估指标包括丙氨酸氨基转移酶（ALT）、丙氨酸氨基转移酶/天冬氨酸氨基转移酶（ALT/AST）比值、肝脂肪变性指数、弗雷明汉肝脂肪变性指数，以及肝纤维化的非侵入性生物标志物（AST 血小板比值指数、纤维化-4 指数），或基线社会人口学、临床和实验室参数。
与安慰剂相比，益生菌对肝脂肪变性和纤维化参数没有影响（HSI 比较的 p=0.940）。然而，亚组分析显示，按主要诊断组分层时，肝脏相关参数存在显著差异（与混合抑郁和焦虑障碍患者相比，在抑郁发作患者中益生菌治疗后肝脂肪变性指数改善更好）或精神药物使用情况（与未使用抗抑郁药物治疗的患者相比，在使用抗抑郁药物治疗的患者中，基于 ALT 的指数改善更好）。讨论了益生菌、药物、抑郁的临床和代谢特征以及与肝脏相关参数变化之间的相互作用。
多种因素可能调节了益生菌在抑郁症患者中假定的保肝作用。需要进一步的研究，包括更大的样本量、不同的益生菌菌株和更长的干预时间，以评估益生菌对该人群肝脏健康的实际意义。
NCT04756544。
