Pontes Karine Scanci da Silva, Guedes Marcella Rodrigues, Souza Priscila Guadagno de, Neves Mario Fritsch Toros, Klein Márcia Regina Simas Torres
Post Graduate Program in Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Rio de Janeiro, Brazil.
Post Graduate Program in Food, Nutrition and Health, Rio de Janeiro State University, Rio de Janeiro, Brazil.
Clin Nutr. 2025 Jul;50:117-127. doi: 10.1016/j.clnu.2025.05.005. Epub 2025 May 15.
BACKGROUND & AIMS: Recent evidence suggests that gut microbiota has a potential role in the pathophysiology of obesity and other cardiovascular disease (CVD) risk factors, including hypertension, dyslipidemia, and type 2 diabetes. However, clinical trials evaluating the effects of probiotics supplementation on these outcomes have found inconsistent results, probably due to the wide heterogeneity in trial designs. In addition, there is a lack of studies investigating whether probiotics can enhance the beneficial effects of caloric restriction in individuals with increased risk of CVD as individuals with hypertension and excess body adiposity. Thus, the aim of this study was to evaluate the effects of multi-strain probiotics supplementation on body adiposity, glycemic homeostasis, lipid profile, and serum adipokine levels in individuals with hypertension and excess body weight following an energy restricted diet.
A randomized, double-blind, placebo controlled clinical trial was conducted for 12 weeks. Were included 66 individuals aged between 40 and 65 years; both sexes; body mass index (BMI) ≥ 25 and < 40 kg/m and diagnosis of hypertension. Were excluded smokers; individuals using probiotics, prebiotics, symbiotics and antibiotics in the last 3 months; presenting diabetes, chronic kidney disease or liver failure; and pregnant and lactating women. Participants were allocated into 2 groups: group with supplementation of 8 probiotic strains in capsules (3 × 10 CFU/day) or control group (placebo capsules). Both groups followed a low-calorie diet. Participants underwent anthropometric, body composition (dual-energy radiological absorptiometry) and biochemical (glucose metabolism, lipid profile, adiponectin, and leptin) evaluation at baseline and at the end of the study.
After 12 weeks of intervention, the probiotics group presented: a) reduction of body weight, BMI, circumferences of waist, hip and neck and waist-to-height ratio; b) decrease in total fat mass (kg); and c) reduction of glycated hemoglobin (HbA1c). In the control group, it was observed: a) significant reduction in all anthropometric variables; b) significant reduction in total fat mass (kg and %), trunk fat mass (kg), visceral fat and load capacity index. In the comparison between groups, there was a higher decrease in HbA1c in the probiotics group (p < 0.05).
Multi-strain probiotics supplementation associated with energy restriction in individuals with excess body weight and hypertension promoted a significant improvement in glucose homeostasis assessed by HbA1c. The clinical trial was registered at www.ensaiosclinicos.gov.br: RBR-7jw4ry.
最近的证据表明,肠道微生物群在肥胖及其他心血管疾病(CVD)风险因素(包括高血压、血脂异常和2型糖尿病)的病理生理学中具有潜在作用。然而,评估补充益生菌对这些结果影响的临床试验结果并不一致,这可能是由于试验设计的广泛异质性所致。此外,缺乏研究调查益生菌是否能增强热量限制对心血管疾病风险增加个体(如高血压和身体肥胖个体)的有益作用。因此,本研究的目的是评估补充多菌株益生菌对能量限制饮食后的高血压和超重个体的身体肥胖、血糖稳态、血脂谱和血清脂肪因子水平的影响。
进行了一项为期12周的随机、双盲、安慰剂对照临床试验。纳入66名年龄在40至65岁之间的个体;男女不限;体重指数(BMI)≥25且<40kg/m²并诊断为高血压。排除吸烟者;在过去3个月内使用过益生菌、益生元、合生元和抗生素的个体;患有糖尿病、慢性肾病或肝功能衰竭的个体;以及孕妇和哺乳期妇女。参与者被分为2组:补充8种益生菌菌株胶囊(3×10⁸CFU/天)的组或对照组(安慰剂胶囊)。两组均遵循低热量饮食。参与者在基线和研究结束时接受人体测量、身体成分(双能X线吸收法)和生化(葡萄糖代谢、血脂谱脂联素和瘦素)评估。
干预12周后,益生菌组出现:a)体重、BMI、腰围、臀围和颈围以及腰高比降低;b)总脂肪量(kg)减少;c)糖化血红蛋白(HbA1c)降低。在对照组中,观察到:a)所有人体测量变量均显著降低;b)总脂肪量(kg和%)、躯干脂肪量(kg)、内脏脂肪和负荷能力指数显著降低。在两组之间的比较中,益生菌组的HbA1c降低幅度更大(p<0.05)。
在超重和高血压个体中,补充多菌株益生菌与能量限制相结合,可使通过HbA1c评估的葡萄糖稳态得到显著改善。该临床试验已在www.ensaiosclinicos.gov.br注册:RBR-7jw4ry。