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Varlas VN, Bohîlțea LC, Suciu N. The Influences of Oral Probiotics on the Immunometabolic Response During Pregnancy and Lactation: A Systematic Review. Nutrients 2025; 17:1535. [PMID: 40362845 PMCID: PMC12073199 DOI: 10.3390/nu17091535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2025] [Revised: 04/26/2025] [Accepted: 04/28/2025] [Indexed: 05/15/2025] Open
Abstract
BACKGROUND/OBJECTIVES In recent years, due to the emergence of antimicrobial resistance, probiotics have been increasingly used during pregnancy and lactation with real maternal-fetal benefits. Probiotic intervention, especially multi-strain probiotics, due to their anti-inflammatory, metabolic, and immunomodulatory actions, can be performed prophylactically and therapeutically with promising results regarding maternal, fetal, and neonatal health. The administration of probiotics can modulate the maternal microbiome, regulate microflora imbalance in various conditions (overweight/obesity, gestational diabetes mellitus (GDM), preeclampsia, allergic diseases), and influence several reactions such as modulating the non-specific cellular immune system, metabolic processes, and inhibition of pathogens. This study aimed to analyze, based on available data, how the administration of probiotic supplements to women during pregnancy can modify immunometabolic responses to microbial dysbiosis to limit weight gain and the risk of obesity, to improve glucose homeostasis and reduce the risk of GDM, to prevent preeclampsia and its effects on maternal-fetal outcomes, and to reduce rates of atopic eczema and allergic diseases in infants. METHODS We performed a systematic search in MEDLINE/PubMed to identify studies that have investigated the effects of probiotic intervention on the immunometabolic response in pregnancy and lactation, especially in women with diabetes, overweight/obesity, preeclampsia, and allergic conditions. RESULTS Fifty-six RCT studies, totaling 15,044 women, matched the inclusion criteria, of which eight were for interventions on the immune response, twenty on allergic conditions, seven on obesity and excess weight gain in pregnancy, and twenty-one on GDM. CONCLUSIONS Due to the heterogeneous structure and the size of the samples, the methodologies, formulations, moment of initiation, and study durations, future research is needed to establish their effectiveness and safety in pregnancy and lactation regarding maternal-fetal health and outcomes in childhood and adult life.
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Affiliation(s)
- Valentin Nicolae Varlas
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania
| | - Laurențiu-Camil Bohîlțea
- Department of Medical Genetics, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Fetal Medicine Excellence Research Center, Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania;
| | - Nicolae Suciu
- Fetal Medicine Excellence Research Center, Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania;
- Department of Obstetrics and Gynecology, Alessandrescu-Rusescu National Institute for Mother and Child Health, Polizu Clinical Hospital, 020395 Bucharest, Romania
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Hemalatha M, Dev A, Mahajan R, De D, Handa S. Non-pharmacological therapies and their efficacy in atopic dermatitis: A narrative review. Indian J Dermatol Venereol Leprol 2025; 0:1-9. [PMID: 40357939 DOI: 10.25259/ijdvl_1076_2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 01/27/2025] [Indexed: 05/15/2025]
Abstract
Atopic dermatitis (AD) is a complex immune-mediated disease characterised by recurrent eczematous lesions and pruritus, which adversely affects the quality of life (QoL). Genetic factors, environmental factors, immune dysregulation, and skin barrier dysfunction contribute to its pathophysiology. Non-pharmacological management strategies aim to preserve the skin barrier, address immune dysregulation, and minimise triggers. In this review, wediscuss various non-pharmacological interventions, including allergen (aeroallergens, food allergens, and contact allergens) avoidance, bathing-related measures, moisturisers, clothing choices, therapies targeting the skin microbiome, and allergen-specific immunotherapy, in addition to education and psychotherapy. Non-pharmacological therapies are essential for the holistic management of AD, but their effectiveness varies, highlighting the need for further research and tailored approaches to individual patient needs.
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Affiliation(s)
- Mude Hemalatha
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anubha Dev
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rahul Mahajan
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Dipankar De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjeev Handa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Pavlidou E, Alexatou O, Tsourouflis G, Antasouras G, Papadopoulou SK, Papandreou D, Sampani A, Giaginis C. Probiotic Supplementation during Pregnancy: Evaluating the Current Clinical Evidence against Gestational Diabetes Mellitus. Curr Diabetes Rev 2025; 21:e260424229418. [PMID: 38676509 DOI: 10.2174/0115733998284749240417052006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/12/2024] [Accepted: 02/28/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) constitutes a common metabolic disorder that could lead to deleterious short- and long-term complications in both the mother and her infant. Probiotic supplementation seems to exert diverse, healthy effects by acting as a preventive agent against various human diseases, including GDM. OBJECTIVE The purpose of the current narrative review was to critically summarize and scrutinize the available clinical studies during the last 15 years (2008-2023) concerning the use of probiotic supplementation during pregnancy as a protecting agent against GDM. METHODS A thorough and in-depth search was performed in the most accurate scientific databases, e.g., PubMed., Scopus, Web of Science, and Google Scholar applying effective, and relevant keywords. RESULTS There are currently some clinical studies suggesting the potential beneficial impact of probiotic supplementation in the prevention and/or co-treatment of GDM. Nevertheless, there is a high heterogeneity amongst the available clinical studies concerning the dosage, the administration duration, the probiotic species types, the method designs and protocols, and the study populations. CONCLUSION Probiotic supplementation at conventional dosages and in combination with a balanced healthy diet, and lifestyle seems to reduce the the risk of developing GDM, while ameliorating the severity of its symptoms. Further clinical studies taking into account the above considerations should be performed to establish conclusive results, while the future meta-analyses should include studies with the feasibly lowest heterogeneity.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, 81400, Greece
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, 81400, Greece
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, University of Athens, 11527 Athens, Greece
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, 81400, Greece
| | - Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Dimitrios Papandreou
- Department of Clinical Nutrition & Dietetics, College of Health University of Sharjah, P.O Box 27272, United Arab Emirates
| | - Anastasia Sampani
- First Department of Pathology, Medical School, University of Athens, 11527, Athens, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, Lemnos, 81400, Greece
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Fernández L, Orgaz B, Rodríguez JM. The Safety of Probiotics Intended for Use in Pregnant and Lactating Women: From a Desirable to a Required Task. Foods 2024; 13:4024. [PMID: 39766967 PMCID: PMC11727567 DOI: 10.3390/foods13244024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2024] [Revised: 12/09/2024] [Accepted: 12/10/2024] [Indexed: 01/15/2025] Open
Abstract
During pregnancy, women undergo changes that affect virtually every organ, apparatus, or system, including the host microbiota. Most pregnancies progress smoothly despite the common presence of minor side-effects arising from such adaptations. However, some women may experience more serious complications, including gestational diabetes mellitus, preeclampsia, or preterm delivery. Probiotics are one of the products most used to try to prevent or treat any of the minor or severe symptoms or complications that women may experience during pregnancy or lactation; however, most of them have never been tested in such populations and, therefore, their efficacy and safety claims are frequently unsubstantiated. Overall, probiotic trials involving pregnant or lactating women have shown that these products are usually well-tolerated and safe although adverse effects may also exist. Therefore, health professionals attending pregnant or lactating women should be aware of their use and monitor their efficacy and safety. In conclusion, probiotics recommendations for pregnant or lactating women should be based on scientific evidence, opting exclusively for those products that have been designed for the specific target or condition that a pregnant or lactating woman may be experiencing or at risk of, and which efficacy and safety has already been convincingly tested in such populations.
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Affiliation(s)
- Leónides Fernández
- Department of Galenic Pharmacy and Food Technology, Complutense University of Madrid, 28040 Madrid, Spain; (L.F.); (B.O.)
- Instituto Pluridisciplinar, Complutense University of Madrid, 28040 Madrid, Spain
| | - Belén Orgaz
- Department of Galenic Pharmacy and Food Technology, Complutense University of Madrid, 28040 Madrid, Spain; (L.F.); (B.O.)
- Instituto Pluridisciplinar, Complutense University of Madrid, 28040 Madrid, Spain
| | - Juan M. Rodríguez
- Instituto Pluridisciplinar, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain
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Sun G, Hou H, Yang S. The effect of probiotics on gestational diabetes mellitus: an umbrella meta-analysis. BMC Endocr Disord 2024; 24:253. [PMID: 39582003 PMCID: PMC11587629 DOI: 10.1186/s12902-024-01751-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 10/10/2024] [Indexed: 11/26/2024] Open
Abstract
BACKGROUND Prior studies indicated the positive effects of probiotics on glycemic regulation in patients with gestational diabetes mellitus (GDM). Nonetheless, the results remain inconclusive. To address this, we conducted an umbrella meta-analysis to evaluate the impact of probiotics on glycemic indicators in GDM. METHODS A comprehensive search was conducted on the PubMed and Scopus databases to identify all relevant meta-analyses of randomized clinical trials published until July 2024. The outcomes included serum hemoglobin A1C (HbA1c), fasting blood insulin (FBI), fasting blood sugar (FBS), homeostatic model assessment for insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), homeostatic model assessment of beta cell function (HOMA-B), C-peptide, and oral glucose tolerance test (OGTT). Standardized mean difference (SMD) was used to test the effects. RESULTS In total, 27 studies, comprising 33,378 participants, were included in the analysis. Probiotics resulted in a significant decrease in FBS (SMD: -0.39, 95% CI: -0.56 to -0.23), especially when administered for ≤ 7 weeks. Significant reductions were also observed in FBI (SMD: -1.99, 95% CI: -2.41 to -1.58), HOMA-IR (SMD: -0.61, 95% CI: -0.72 to -0.50), and HOMA-B (SMD: -24.58, 95% CI: -30.59 to -18.56). Moreover, supplementation with probiotics significantly improved QUICKI (SMD: 0.007, 95% CI: 0.004 to 0.01). There was significant evidence of heterogeneity and publication bias. No significant effects were observed on 1-h OGTT, 2-h OGTT, HbA1c, and C-peptide. No dose-specific effect was observed. CONCLUSIONS Supplementation with probiotics could improve glycemic control in women with GDM. The effects of probiotics on HOMA-IR, HOMA-B, and fasting insulin were clinically important, while, their effect on FBS was not clinically important.
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Affiliation(s)
- Guixia Sun
- Department of Gynecology and Obstetrics, Shanxi Provincial Children's Hospital (Shanxi Provincial Maternal and Child Health Hospital), No.13 Xinmin North Street, Taiyuan, Shanxi, 030001, China.
| | - Hongli Hou
- Department of Gynecology and Obstetrics, Shanxi Provincial Children's Hospital (Shanxi Provincial Maternal and Child Health Hospital), No.13 Xinmin North Street, Taiyuan, Shanxi, 030001, China
| | - Shanshan Yang
- Department of Gynecology and Obstetrics, Shanxi Provincial Children's Hospital (Shanxi Provincial Maternal and Child Health Hospital), No.13 Xinmin North Street, Taiyuan, Shanxi, 030001, China
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Ali YA, Sharara M, Mahrous M, Rezk AA, Abuali A, Seoudy MA, Elnaghy MY, Elsekaily AE, Elkholy ME, Ragab KM, Badawy MM, Kamal I, Fathallah AH. Maternal and Neonatal Efficacy and Safety Outcomes of Myo-Inositol in Women With or at High Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. Diabetes Spectr 2024; 38:82-92. [PMID: 39959527 PMCID: PMC11825409 DOI: 10.2337/ds23-0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2025]
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Garcia-Gutierrez E, O’Mahony AK, Dos Santos RS, Marroquí L, Cotter PD. Gut microbial metabolic signatures in diabetes mellitus and potential preventive and therapeutic applications. Gut Microbes 2024; 16:2401654. [PMID: 39420751 PMCID: PMC11492678 DOI: 10.1080/19490976.2024.2401654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 07/08/2024] [Accepted: 09/03/2024] [Indexed: 10/19/2024] Open
Abstract
Diabetes mellitus can be subdivided into several categories based on origin and clinical characteristics. The most common forms of diabetes are type 1 (T1D), type 2 diabetes (T2D) and gestational diabetes mellitus (GDM). T1D and T2D are chronic diseases affecting around 537 million adults worldwide and it is projected that these numbers will increase by 12% over the next two decades, while GDM affects up to 30% of women during pregnancy, depending on diagnosis methods. These forms of diabetes have varied origins: T1D is an autoimmune disease, while T2D is commonly associated with, but not limited to, certain lifestyle patterns and GDM can result of a combination of genetic predisposition and pregnancy factors. Despite some pathogenic differences among these forms of diabetes, there are some common markers associated with their development. For instance, gut barrier impairment and inflammation associated with an unbalanced gut microbiota and their metabolites may be common factors in diabetes development and progression. Here, we summarize the microbial signatures that have been linked to diabetes, how they are connected to diet and, ultimately, the impact on metabolite profiles resulting from host-gut microbiota-diet interactions. Additionally, we summarize recent advances relating to promising preventive and therapeutic interventions focusing on the targeted modulation of the gut microbiota to alleviate T1D, T2D and GDM.
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Affiliation(s)
- Enriqueta Garcia-Gutierrez
- Food Biosciences Department, Teagasc Food Research Centre, Fermoy, Co. Cork, Ireland
- APC Microbiome Ireland, University College Cork, Co. Cork, Ireland
- VistaMilk SFI Research Centre, Fermoy, Co. Cork, Ireland
- Departamento de Ingeniería Agronómica, Instituto de Biotecnología Vegetal, ETSIA-Universidad Politécnica de Cartagena, Cartagena, Spain
| | - A. Kate O’Mahony
- Food Biosciences Department, Teagasc Food Research Centre, Fermoy, Co. Cork, Ireland
- APC Microbiome Ireland, University College Cork, Co. Cork, Ireland
- School of Microbiology, University College Cork, Co. Cork, Ireland
| | - Reinaldo Sousa Dos Santos
- Instituto de Investigación, Desarrollo e Innovación en Biotecnología Sanitaria de Elche (IDiBE), Universidad Miguel Hernández de Elche, Elche, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Marroquí
- Instituto de Investigación, Desarrollo e Innovación en Biotecnología Sanitaria de Elche (IDiBE), Universidad Miguel Hernández de Elche, Elche, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Paul D. Cotter
- Food Biosciences Department, Teagasc Food Research Centre, Fermoy, Co. Cork, Ireland
- APC Microbiome Ireland, University College Cork, Co. Cork, Ireland
- VistaMilk SFI Research Centre, Fermoy, Co. Cork, Ireland
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DuPont HL, Salge MMH. The Importance of a Healthy Microbiome in Pregnancy and Infancy and Microbiota Treatment to Reverse Dysbiosis for Improved Health. Antibiotics (Basel) 2023; 12:1617. [PMID: 37998819 PMCID: PMC10668833 DOI: 10.3390/antibiotics12111617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The microbiome of newborn infants during the first 1000 days, influenced early on by their mothers' microbiome health, mode of delivery and breast feeding, orchestrates the education and programming of the infant's immune system and determines in large part the general health of the infant for years. METHODS PubMed was reviewed for maternal infant microbiome health and microbiota therapy in this setting with prebiotics, probiotics, vaginal seeding and fecal microbiota transplantation (FMT). RESULTS A healthy nonobese mother, vaginal delivery and strict breast feeding contribute to microbiome health in a newborn and young infant. With reduced microbiome diversity (dysbiosis) during pregnancy, cesarean delivery, prematurity, and formula feeding contribute to dysbiosis in the newborn. Microbiota therapy is an important approach to repair dysbiosis in pregnant women and their infants. Currently available probiotics can have favorable metabolic effects on mothers and infants, but these effects are variable. In research settings, reversal of infant dysbiosis can be achieved via vaginal seeding or FMT. Next generation probiotics in development should replace current probiotics and FMT. CONCLUSIONS The most critical phase of human microbiome development is in the first 2-3 years of life. Preventing and treating dysbiosis during pregnancy and early life can have a profound effect on an infant's later health.
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Affiliation(s)
- Herbert L. DuPont
- Division of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas, Houston, TX 77030, USA
- Department of Internal Medicine, University of Texas McGovern Medical School, Houston, TX 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Kelsey Research Foundation, Houston, TX 77005, USA
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Tabatabaeizadeh SA, Tafazoli N. Effect of probiotic yogurt on gestational diabetes mellitus: A systematic review and meta-analysis. Diabetes Metab Syndr 2023; 17:102758. [PMID: 37062185 DOI: 10.1016/j.dsx.2023.102758] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 03/29/2023] [Accepted: 04/01/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND AND AIMS Gestational diabetes mellitus is one of the important complications of pregnancy and is related to many adverse events. There is evidence that probiotics can be considered a preventive and therapeutic option in gestational diabetes mellitus. In this meta-analysis, we have focused on the effect of probiotic yogurt as a natural product on gestational diabetes mellitus. METHODS A systematic literature search was done through PUBMED/Medline, Google Scholar, Cochrane Library, and EBSCO up to December 2022. This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines for the evaluation of the effect of probiotic yogurt on gestational diabetes mellitus. RESULTS Four manuscripts with a total of 533 participants were included in this meta-analysis. There was a statistically significant association between probiotic yogurt and reduced risk of gestational diabetes mellitus (Pooled OR 0.35; 95% CI 0.19-0.62; I2 = 0.0%). Furthermore, the mean reduction in the fasting plasma glucose was significantly higher in the probiotic yogurt groups (Hedges' g = -0.37; 95% CI -0.68 to -0.05; I2 = 0.0%). CONCLUSION This meta-analysis suggests that probiotic yogurt lowers the risk of gestational diabetes mellitus. Also, it is related to a significant reduction in fasting plasma glucose. These findings promise that probiotic yogurt could be regarded as a safe and low-cost therapy and preventive option for gestational diabetes mellitus. However, more randomized controlled trials with different doses and more probiotic strains with varying systems of delivery are warranted.
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Hyseni E, Glavas Dodov M. Probiotics in dermatological and cosmetic products – application and efficiency. MAKEDONSKO FARMACEVTSKI BILTEN 2023. [DOI: 10.33320/maced.pharm.bull.2022.68.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The term “probiotics” has first been used in 1907 by Elie Metchnikoff. Since then, probiotics have been part of research not only in regards of digestive health, but also inflammatory diseases. Lately, there has been an increased interest of probiotic’s effects in skincare. The management of atopic dermatitis, acne, psoriasis, photo aging, skin cancer, intimate care, oral care, wound healing is getting harder each passing day, due to increased antibiotic resistance and other side effects of conventional therapy. Therefore, new ingredients have been investigated and probiotics have been proved to be effective in treating various skin conditions.
This review aims to evaluate the scientific evidence on topical and oral probiotics, and to evaluate the efficacy of cosmetic and dermatological products containing probiotics. Many studies have shown that skin and gut microbiome alterations have an important role in skin health. Although this is a new topic in dermatology and cosmetology, there have been some promising results in lots of research studies that the use of probiotics in cosmetic products may help improve the patient’s outcome. While oral probiotics have been shown to promote gut health, which influences the host immune system and helps treat different skin diseases, the mechanism of action of topical probiotics is not yet fully understood. Although the number of commercial probiotic cosmetic products released in the market is increasing and most of the studies have not shown any serious side effect of probiotics, further studies, in larger and heterogeneous groups are needed.
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Affiliation(s)
- Edita Hyseni
- Center of Pharmaceutical nanotechnology, Faculty of Pharmacy, Ss Cyril and Methodius University in Skopje, Majka Tereza 47, 1000 Skopje, N. Macedonia
| | - Marija Glavas Dodov
- Center of Pharmaceutical nanotechnology, Faculty of Pharmacy, Ss Cyril and Methodius University in Skopje, Majka Tereza 47, 1000 Skopje, N. Macedonia
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Deng YF, Wu LP, Liu YP. Probiotics for preventing gestational diabetes in overweight or obese pregnant women: A review. World J Clin Cases 2022; 10:13189-13199. [PMID: 36683622 PMCID: PMC9851018 DOI: 10.12998/wjcc.v10.i36.13189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/12/2022] [Accepted: 12/08/2022] [Indexed: 12/26/2022] Open
Abstract
Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit to the host. Specific probiotics or probiotic foods can be used to reduce the risk of diseases associated with aberrant gut microbiota composition. The incidence of gestational diabetes mellitus (GDM) has increased annually with the proportion of overweight and obese people. Overweight or obese pregnant women are at high risk of GDM and have obvious changes in gut microbiota compared with normal-weight pregnant women. Specific probiotics or probiotic foods may alter gut microbiota in overweight or obese pregnant women and inhibit the expression of inflammatory factors, consequently resulting in weight loss and reduced insulin resistance. This review discusses the mechanism of probiotics on GDM, as well as the dose, method and duration of probiotics use, and summarizes current evidence on probiotics in improving glucose metabolism and other maternal and infant outcomes in overweight/obese pregnant women.
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Affiliation(s)
- Ya-Fang Deng
- Chinese Academy of Medical Sciences and Peking Union Medical College, School of Nursing, Beijing 100730, China
| | - Li-Ping Wu
- Chinese Academy of Medical Sciences and Peking Union Medical College, School of Nursing, Beijing 100730, China
| | - Yan-Ping Liu
- Department of Clinical Nutrition, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China
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The Importance of the Microbiota in Shaping Women’s Health—The Current State of Knowledge. Appl Microbiol 2022. [DOI: 10.3390/applmicrobiol3010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
According to current knowledge, a properly colonized human microbiota contributes to the proper functioning of the body. The composition of the natural flora changes depending on age, health, living conditions, and the use of antimicrobial agents: antibiotics, disinfectants, and some cosmetics. The human body is diversely populated with microorganisms and undergoes constant changes under the influence of various factors, and its proper composition is extremely important for the proper functioning of the body. Given the above, it was decided that we would review current scientific research that explains the cause–effect relationship between the composition of microorganisms populating the human body and health, focusing on women’s health. As a result, an overview paper was prepared based on 109 scientific sources from 2009–2022. Special attention was paid to the most recent scientific studies of the last five years, which account for more than 75% of the cited sources.
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Çetinkaya Özdemir S, Küçüktürkmen Paşa B, Metin T, Dinçer B, Sert H. The effect of probiotic and synbiotic use on glycemic control in women with gestational diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract 2022; 194:110162. [PMID: 36403680 DOI: 10.1016/j.diabres.2022.110162] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/26/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022]
Abstract
AIMS To investigate the impact of probiotic/synbiotic use on glycemic control in women with gestational diabetes. METHODS We searched the PubMed, Medline, Scopus, ScienceDirect, Web of Science, Cochrane Central Register of Controlled Trials, Dergipark, and Council of Higher Education Thesis Center databases through March 2022. Screening was performed according to the population, intervention, comparison, outcome and study type. This systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Review and meta-analyses (PRISMA-2020) statement. RESULTS Eight RCTs involving 551 patients were included in the meta-analysis. Probiotic use in women with gestational diabetes significantly decreased fasting blood glucose (mean difference: -1.43; 95 % CI: -2.78 to -0.09, p: 0.04) and serum insulin (mean difference: -3.66; 95 % CI: -5.04 to -2.27, p < 0.001). Moreover, the use of probiotics and synbiotics significantly reduced the HOMA-IR level compared to the control group (probiotic group: mean difference: -0.74; 95 % CI: -1.05 to -0.44, p < 0.001; synbiotic group: mean difference: -0.68; 95 % CI: -1.26 to -0.09, p: 0.02). CONCLUSIONS The use of probiotics in women with GDM reduced fasting plasma glucose, fasting serum insulin, and HOMA-IR levels. In addition, the use of synbiotics decreased HOMA-IR. Probiotic/synbiotic use is promising as a potential therapy to assist in glycemic control in gestational diabetes. Further high-quality studies are required to determine their safety.
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Affiliation(s)
- Serap Çetinkaya Özdemir
- Faculty of Health Sciences, Department of Internal Medicine Nursing, Sakarya University, Sakarya 54050, Turkey.
| | - Büşra Küçüktürkmen Paşa
- PhD student, Institute of Health Sciences, Department of Midwifery, Sakarya University, Sakarya, 54050, Turkey
| | - Tuba Metin
- Simav Vocational School of Health Services, Kutahya Health Sciences University, Kutahya 43500, Turkey
| | - Berna Dinçer
- Faculty of Health Sciences, Department of Internal Medicine Nursing, İstanbul Medeniyet University, İstanbul 34862, Turkey
| | - Havva Sert
- Faculty of Health Sciences, Department of Internal Medicine Nursing, Sakarya University, Sakarya 54050, Turkey
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14
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Ionescu RF, Enache RM, Cretoiu SM, Gaspar BS. Gut Microbiome Changes in Gestational Diabetes. Int J Mol Sci 2022; 23:12839. [PMID: 36361626 PMCID: PMC9654708 DOI: 10.3390/ijms232112839] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 08/27/2023] Open
Abstract
Gestational diabetes mellitus (GDM), one of the most common endocrine pathologies during pregnancy, is defined as any degree of glucose intolerance with onset or first discovery in the perinatal period. Physiological changes that occur in pregnant women can lead to inflammation, which promotes insulin resistance. In the general context of worldwide increasing obesity in young females of reproductive age, GDM follows the same ascending trend. Changes in the intestinal microbiome play a decisive role in obesity and the development of insulin resistance and chronic inflammation, especially in patients with type 2 diabetes mellitus (T2D). To date, various studies have also associated intestinal dysbiosis with metabolic changes in women with GDM. Although host metabolism in women with GDM has not been fully elucidated, it is of particular importance to analyze the available data and to discuss the actual knowledge regarding microbiome changes with potential impact on the health of pregnant women and newborns. We analyzed peer-reviewed journal articles available in online databases in order to summarize the most recent findings regarding how variations in diet and metabolic status of GDM patients can contribute to alteration of the gut microbiome, in the same way that changes of the gut microbiota can lead to GDM. The most frequently observed alteration in the microbiome of patients with GDM was either an increase of the Firmicutes phylum, respectively, or a decrease of the Bacteroidetes and Actinobacteria phyla. Gut dysbiosis was still present postpartum and can impact the development of the newborn, as shown in several studies. In the evolution of GDM, probiotic supplementation and regular physical activity have the strongest evidence of proper blood glucose control, favoring fetal development and a healthy outcome for the postpartum period. The current review aims to summarize and discuss the most recent findings regarding the correlation between GDM and dysbiosis, and current and future methods for prevention and treatment (lifestyle changes, pre- and probiotics administration). To conclude, by highlighting the role of the gut microbiota, one can change perspectives about the development and progression of GDM and open up new avenues for the development of innovative therapeutic targets in this disease.
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Affiliation(s)
- Ruxandra Florentina Ionescu
- Department of Cardiology I, Central Military Emergency Hospital “Dr Carol Davila”, 030167 Bucharest, Romania
- Department of Morphological Sciences, Cell and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Robert Mihai Enache
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Sanda Maria Cretoiu
- Department of Morphological Sciences, Cell and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Bogdan Severus Gaspar
- Surgery Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Surgery Clinic, Bucharest Emergency Clinical Hospital, 014461 Bucharest, Romania
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15
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Kamińska K, Stenclik D, Błażejewska W, Bogdański P, Moszak M. Probiotics in the Prevention and Treatment of Gestational Diabetes Mellitus (GDM): A Review. Nutrients 2022; 14:4303. [PMID: 36296986 PMCID: PMC9608451 DOI: 10.3390/nu14204303] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022] Open
Abstract
Gestational diabetes mellitus (GDM)is one of the most common perinatal pathologies, with a prevalence of 5-20% depending on the population or diagnostic standards. It is diagnosed when glucose intolerance is first detected during pregnancy. In the pathogenesis of GDM, genetic, environmental, and pregnancy-related factors (excessive fat storage and increased adipokine and cytokine secretion) play important roles. A growing amount of scientific data has indicated the role of gut microbiota (GM) dysbiosis in the development of glucose intolerance during pregnancy. Previous studies have indicated that, in comparison to healthy pregnant women, GDM individuals have a greater abundance of bacteria belonging to the genera Ruminococcus, Eubacterium, and Prevotella and a lower number of bacteria belonging to the genera Bacteroides, Parabacteroides, Roseburia, Dialister, and Akkermansia. Recently, many studies have focused on treating GDM with methods targeting GM. Several previous studies have analyzed the effect of probiotics on the course of GDM, but their data are inconclusive. In view of this state, the aim of the study was to collect and comprehensively discuss current knowledge regarding the role of probiotic supplementation in preventing and treating GDM. According to the analyzed data, probiotics have a positive influence on glycemic control and are a promising tool for lowering the frequency of GDM. However, further studies must be conducted to determine the optimal model of probiotic therapy (strain, dose, time of intervention, etc.) in pregnant women with GDM.
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Affiliation(s)
- Klaudia Kamińska
- Student Scientific Club of Clinical Dietetics, Department of the Treatment of Obesity and Metabolic Disorders, and of Clinical Dietetics, Poznań University of Medical Sciences, Szamarzewskiego 82/84, 60-569 Poznan, Poland
| | - Dominika Stenclik
- Student Scientific Club of Clinical Dietetics, Department of the Treatment of Obesity and Metabolic Disorders, and of Clinical Dietetics, Poznań University of Medical Sciences, Szamarzewskiego 82/84, 60-569 Poznan, Poland
| | - Wiktoria Błażejewska
- Student Scientific Club of Clinical Dietetics, Department of the Treatment of Obesity and Metabolic Disorders, and of Clinical Dietetics, Poznań University of Medical Sciences, Szamarzewskiego 82/84, 60-569 Poznan, Poland
| | - Paweł Bogdański
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, 60-569 Poznan, Poland
| | - Małgorzata Moszak
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, 60-569 Poznan, Poland
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16
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Zarezadeh M, Musazadeh V, Faghfouri AH, Sarmadi B, Jamilian P, Jamilian P, Tutunchi H, Dehghan P. Probiotic therapy, a novel and efficient adjuvant approach to improve glycemic status: An umbrella meta-analysis. Pharmacol Res 2022; 183:106397. [PMID: 35981707 DOI: 10.1016/j.phrs.2022.106397] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/16/2022] [Accepted: 08/12/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Probiotics exert several promoting effects on the glycemic status, however, the results of meta-analyses are inconsistent. we conducted an umbrella meta-analysis, across existing systematic reviews and meta-analyses of clinical trials to determine the definite effects of supplementation with probiotics on glycemic indices. METHODS A comprehensive systematic search of PubMed/Medline, Scopus, EMBASE, and Web of Science was carried out till August 2021. The random-effects model was employed to conduct meta-analysis. Meta-analysis studies of randomized clinical trials examining the impacts of probiotics supplementation on glycemic indices were qualified in the current umbrella meta-analysis. RESULTS 48 articles out of 693 in the literature search qualified for inclusion in the umbrella meta-analysis. Pooled effects of probiotics on fasting plasma glucose (FPG), hemoglobin A1C (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), and insulin levels were reported in articles 45, 21, 35, and 33, respectively. The analysis indicated a significant decrease of FPG (ES= -0.51 mg/dL; 95% CI: -0.63, -0.38, p < 0.001), HbA1c (ES = -0.32 mg/dL; 95% CI: -0.44, -0.20, p < 0.001), HOMA-IR (ES= -0.56; 95% CI: -0.66, -0.47, p < 0.001), and insulin levels (ES= -1.09 IU/mL; 95% CI: -1.37, -0.81, p = 0.006) by probiotics supplementation. CONCLUSION Probiotics have amending effects on FPG, HbA1c, HOMA-IR, and insulin levels. A < 8-week period of probiotic supplementation in the moderate dosages (108 or 109 CFU) is an efficacious approach in improving glycemic parameters. Overall, probiotics could be recommended as an adjuvant anti-hyperglycemic agent.
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Affiliation(s)
- Meysam Zarezadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Nutrition Research Center, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vali Musazadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Hossein Faghfouri
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Bahareh Sarmadi
- Department of Nutrition sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Parsa Jamilian
- Keele University School of Medicine, Keele University, Staffordshire, UK
| | - Parmida Jamilian
- School of Pharmacy and Bio Engineering, Keele University, Staffordshire, UK
| | - Helda Tutunchi
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Dehghan
- Nutrition Research Center, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.
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17
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Zhang L, Hu X, Wang Y, He C, Yu J, Fang X, Zhang Y, Xu X, Yang J. Effects of probiotic supplementation on glucose metabolism in pregnant women without diabetes: a systematic review and meta-analysis. Food Funct 2022; 13:8388-8398. [PMID: 35856090 DOI: 10.1039/d1fo04333a] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: The preventive effects of probiotic supplementation against gestational diabetes mellitus (GDM) in pregnant women remain unclear. The objective of this review was to investigate the effect of probiotic supplementation on the profiles of glucose metabolism in pregnant women without diabetes. The published literature was retrieved and screened from PubMed, Embase, Web of Science, CNKI (China National Knowledge Infrastructure), Wanfang, and Cochrane Center Register of Controlled Trails up to April 1st, 2021. Random controlled trials (RCTs) of probiotic supplementation on pregnant women without GDM were included. Results: 12 RCTs (2213 participants) were eligible for meta-analyses. Overall, probiotic supplementation significantly reduced GDM incidence (Risk Ratio (RR) = 0.62, 95% CI: 0.39-0.99), serum fasting blood glucose (FBG) (Mean Difference (MD) = -0.14 mmol L-1; 95% CI: -0.26 mmol L-1, -0.01 mmol L-1), insulin concentration (MD = -1.91 pmol L-1, 95% CI: -2.41 to -1.41), the homeostasis model assessment of insulin resistance (HOMA-IR) (MD = -0.32 mmol L-1; 95% CI: -0.42 mmol L-1, -0.22 mmol L-1), and Quantitative Insulin sensitivity Check Index (QUICKI) (MD = 0.02, 95% CI: 0.01,0.03) in pregnant women. Probiotic supplementation had no significant effects on the results of the oral glucose tolerance test (OGTT) (1 h OGTT, MD = -0.10, 95% CI: -0.30, 0.09; 2 h OGTT, MD = -0.06, 95% CI: -0.31, 0.20). Conclusion: This meta-analysis suggested that probiotic supplementation may lead to an improvement in glycemic control and reduction of GDM incidence in pregnant women.
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Affiliation(s)
- Lijun Zhang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Xiaoqiang Hu
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Ying Wang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Chuncao He
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Jingjing Yu
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Xuexian Fang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Yan Zhang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Xianrong Xu
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Jun Yang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China. .,Zhejiang Provincial Center for Uterine Cancer Diagnosis and Therapy Research, The Affiliated Women's Hospital, Zhejiang University, Hangzhou, 310006, China
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18
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Hsu CY, Chen CL, Tsai LY, Tsai JM. Pregnancy-Related Stress Among Pregnant Women Receiving Tocolytic and Non-Tocolytic Treatments Where Both Used Complementary Medicine. Front Pharmacol 2022; 13:870659. [PMID: 35721134 PMCID: PMC9201384 DOI: 10.3389/fphar.2022.870659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: This study aimed to compare the pregnancy stress among pregnant women in receiving tocolytic and non-tocolytic treatments where both used complementary medicine. Methods: A cross-sectional survey was conducted among 35 pregnant women receiving tocolytic treatment and 35 receiving non-tocolytic treatment, where both used complementary medicine in a medical center in central Taiwan. A basic information questionnaire that contained demographic variables and types of complementary medicine used and the Pregnancy Stress Rating Scale were used for the analysis. Results: The types of complementary medicines were surveyed using the multiple-choice questionnaire. Natural products (77.5%) were most commonly used by pregnant women receiving tocolytic treatment, followed by alternative medicine (13.75%), manipulative and body-based practices (5%), and mind and body medicine (3.75%). In pregnant women who were receiving non-tocolytic treatment, natural products (59.1%) were most commonly used, followed by manipulative and body-based practices (16.4%), alternative medicine (15.4%), mind and body medicine (7.3%), and energy therapy (1.8%). According to the analysis of covariance test results, while both used complementary medicine in groups, pregnant women receiving tocolytic treatment were less stressed than those who were receiving non-tocolytic treatment (Pregnancy Stress Rating Scale score, p = 0.038), especially in dimension 2 (stress caused by infant care and changes in family relationships) (p = 0.015) and dimension 5 (stress caused by changes in physical appearance and function) (p = 0.008), which showed statistically significant differences (p < 0.05). Linear regression analysis results showed that the gestational age significantly associated with pregnancy stress (Pregnancy Stress Rating Scale score, p = 0.029; dimension 2, p = 0.016; and dimension 5, p = 0.001). Conclusion: Among both who used complementary medicine, pregnancy stress was significantly lower in pregnant women who were receiving tocolytic treatment than in those who were receiving non-tocolytic treatment. This finding can be used as a reference for future pregnant women’s health studies.
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Affiliation(s)
- Chen-Yuan Hsu
- College of Nursing and Health Sciences, Dayeh University, Dacun, Taiwan
| | - Ching-Li Chen
- College of Nursing and Health Sciences, Dayeh University, Dacun, Taiwan.,Taichung Veterans General Hospital, Taichung, Taiwan
| | - Li-Yun Tsai
- College of Nursing and Health Sciences, Dayeh University, Dacun, Taiwan
| | - Jung-Mei Tsai
- College of Nursing and Health Sciences, Dayeh University, Dacun, Taiwan.,Mackay Memorial Hospital, Taipei, Taiwan.,Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.,Department of Nursing, Mackay Medical College, New Taipei, Taiwan
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19
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Chen L, Ni Y, Wu X, Chen G. Probiotics for the prevention of atopic dermatitis in infants from different geographic regions: a systematic review and meta-analysis. J DERMATOL TREAT 2022; 33:2931-2939. [PMID: 35708329 DOI: 10.1080/09546634.2022.2091101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BackgroundAtopic dermatitis (AD) is a common skin disease during infancy, but the preventive effect of probiotics on AD remains unclear.AimTo evaluate the efficacy of probiotic supplementation for the prevention of AD in infants.MethodsPubMed, Cochrane Library, and Embase databases were reviewed for relevant randomized controlled trials (RCTs). Two authors independently extracted the data. The primary endpoint was the risk of AD in infants. Risk ratio (RR) and 95% confidence interval (CI) were calculated.ResultsA total of 20 related articles including 22 studies were included. A significant reduction in AD risk was revealed for the probiotic group compared to the control group (RR 0.76; 95% CI 0.67-0.87). Subgroup analyses by participant receiving intervention revealed that not only probiotics given to mother (RR 0.70; 95% CI 0.57-0.85) or given to mother and infant (RR 0.76; 95% CI 0.61-0.95) were effective in preventing AD in infants, and probiotics given to infants alone (RR 0.76; 95% CI 0.60-0.96) still effectively decreased the risk of AD.ConclusionProbiotic supplementation reduced the risk of developing AD in infants. Furthermore, probiotic supplementation given to mother or to mother and infant could effectively prevent AD in infants.
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Affiliation(s)
- Lifeng Chen
- Pritzker School of Molecular Engineering, University of Chicago, USA
| | - Yongshan Ni
- Fujian Medical University Union Hospital, Fujian, China
| | - Xingdong Wu
- Xiamen Children's Hospital, Children's Hospital of Fudan University Xiamen Branch, Xiamen, China
| | - Guixia Chen
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
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20
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Chen J, Yang Y, Yu N, Sun W, Yang Y, Zhao M. Relationship between gut microbiome characteristics and the effect of nutritional therapy on glycemic control in pregnant women with gestational diabetes mellitus. PLoS One 2022; 17:e0267045. [PMID: 35427393 PMCID: PMC9012359 DOI: 10.1371/journal.pone.0267045] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/31/2022] [Indexed: 12/15/2022] Open
Abstract
The purpose of this study was to explore the relationship between the characteristics of gut microbiome and the effect of medical nutrition therapy (MNT) on glycemic control in pregnant women with gestational diabetes mellitus (GDM). Seventy-four pregnant women newly diagnosed with GDM received MNT for one-week. The effect of glycemic control was evaluated by fasting and 2-hour postprandial blood glucose; and stool samples of pregnant women were collected to detect the gut microbiome before and after MNT. We used a nested case-control study design, with pregnant women with GDM who did not meet glycemic standards after MNT as the ineffective group and those with an age difference of ≤5 years, matched for pre-pregnancy body mass index (BMI) 1:1, and meeting glycemic control criteria as the effective group. Comparison of the gut microbiome characteristics before MNT showed that the ineffective group was enriched in Desulfovibrio, Aeromonadales, Leuconostocaceae, Weissella, Prevotella, Bacillales_Incertae Sedis XI, Gemella and Bacillales, while the effective group was enriched in Roseburia, Clostridium, Bifidobacterium, Bifidobacteriales, Bifidobacteriaceae, Holdemania and Proteus. After treatment, the effective group was enriched in Bifidobacterium and Actinomycete, while the ineffective group was enriched in Holdemania, Proteus, Carnobacteriaceae and Granulicatella. In conclusion, the decrease in the abundance of characteristic gut microbiome positively correlated with blood glucose may be a factor influencing the poor hypoglycemic effect of MNT in pregnant women with GDM. Abundance of more characteristic gut microbiome negatively correlated with blood glucose could help control blood glucose in pregnant women with GDM.
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Affiliation(s)
- Jing Chen
- School of Nursing, Anhui Medical University, Hefei, Anhui Province, The people’s Republic of China
| | - Yuying Yang
- Division of Life Sciences and Medicine, Department of Nursing, Hefei Ion Medical Center, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui Province, The people’s Republic of China
| | - Ningning Yu
- School of Nursing, Anhui Medical University, Hefei, Anhui Province, The people’s Republic of China
| | - Wanxiao Sun
- School of Nursing, Anhui Medical University, Hefei, Anhui Province, The people’s Republic of China
| | - Yuanyuan Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, The people’s Republic of China
| | - Mei Zhao
- School of Nursing, Anhui Medical University, Hefei, Anhui Province, The people’s Republic of China
- * E-mail:
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21
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Vitacolonna E, Masulli M, Palmisano L, Stuppia L, Franzago M. Inositols, Probiotics, and Gestational Diabetes: Clinical and Epigenetic Aspects. Nutrients 2022; 14:1543. [PMID: 35458105 PMCID: PMC9028601 DOI: 10.3390/nu14081543] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 03/30/2022] [Accepted: 04/05/2022] [Indexed: 02/06/2023] Open
Abstract
There is growing interest in the potential role of different stereoisomers of inositol or their combination as well as probiotics supplementation in healthy glucose metabolism during pregnancy and in promoting offspring health. The aim of this review is to clarify the effects of several inositol and probiotics-based supplements in the prevention and treatment of gestational diabetes (GDM). Moreover, we will discuss the epigenetic aspects and their short- and long-term effects in response to probiotic intervention as well as the possible implications of these findings in guiding appropriate supplementation regimens in pregnancy.
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Affiliation(s)
- Ester Vitacolonna
- Department of Medicine and Aging, School of Medicine and Health Sciences, “G. d’Annunzio” University, Chieti-Pescara, Via dei Vestini, 66100 Chieti, Italy;
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University, Chieti-Pescara, 66100 Chieti, Italy;
| | - Maria Masulli
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (M.M.); (L.P.)
| | - Luisa Palmisano
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (M.M.); (L.P.)
| | - Liborio Stuppia
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University, Chieti-Pescara, 66100 Chieti, Italy;
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University, Chieti-Pescara, 66100 Chieti, Italy
| | - Marica Franzago
- Department of Medicine and Aging, School of Medicine and Health Sciences, “G. d’Annunzio” University, Chieti-Pescara, Via dei Vestini, 66100 Chieti, Italy;
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University, Chieti-Pescara, 66100 Chieti, Italy;
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22
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Mahdizade Ari M, Teymouri S, Fazlalian T, Asadollahi P, Afifirad R, Sabaghan M, Valizadeh F, Ghanavati R, Darbandi A. The effect of probiotics on gestational diabetes and its complications in pregnant mother and newborn: A systematic review and meta-analysis during 2010-2020. J Clin Lab Anal 2022; 36:e24326. [PMID: 35243684 PMCID: PMC8993604 DOI: 10.1002/jcla.24326] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 12/17/2022] Open
Abstract
This study was aimed to evaluate the effect of probiotics consumption on gestational diabetes (GD) and its complications in pregnant mother and newborn. The study was registered on PROSPERO (CRD42021243409) and all the enrolled articles were collected from four databases (Medline, Scopus, Embase, and Google Scholar) as randomized controlled trials (RCTs) from 2010 to 2020. A total of 4865 study participants from 28 selected studies were included in this review. The present meta‐analysis showed that the consumption of probiotics supplementation has the potential to decrease GD‐predisposing metabolic parameters such as blood glucose level, lipid profile, inflammation, and oxidative markers which may reduce GD occurrence among pregnant women.
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Affiliation(s)
- Marzie Mahdizade Ari
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Microbial Biotechnology Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Samane Teymouri
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Microbial Biotechnology Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Tayebeh Fazlalian
- Department of Microbial Biotechnology, Tehran Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Parisa Asadollahi
- Department of Microbiology, Faculty of medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Roghayeh Afifirad
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fateme Valizadeh
- Department of Endodontics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Atieh Darbandi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Microbial Biotechnology Research Centre, Iran University of Medical Sciences, Tehran, Iran
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23
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Amirani E, Zatollah Asemi, Taghizadeh M. The effects of selenium plus probiotics supplementation on glycemic status and serum lipoproteins in patients with gestational diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Clin Nutr ESPEN 2022; 48:56-62. [DOI: 10.1016/j.clnesp.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/02/2022] [Accepted: 02/08/2022] [Indexed: 11/26/2022]
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24
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Probiotic Supplements Improve Blood Glucose and Insulin Resistance/Sensitivity among Healthy and GDM Pregnant Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9830200. [PMID: 34603479 PMCID: PMC8481047 DOI: 10.1155/2021/9830200] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/27/2021] [Indexed: 12/11/2022]
Abstract
Background Probiotic supplements may be seen as a promising way to improve glucose metabolism. This study aimed to evaluate the effects of probiotic supplements on blood glucose, insulin resistance/sensitivity, and prevention of gestational diabetes mellitus (GDM) among pregnant women. Methods Eleven electronic databases were searched from inception to May 2020. Two authors independently identified randomized controlled trials (RCTs), assessed the eligibility and quality of the included studies, and then extracted data. The primary outcomes were fasting plasma glucose (FPG), 1 h and 2 h plasma glucose after 75 g oral glucose tolerance test (OGTT), HbA1c, fasting plasma insulin, insulin resistance, and insulin sensitivity. Fixed and random effect models were used to pool the results. Results A total of 20 RCTs involving 2972 participants were included according to the inclusion and exclusion criteria. The pooled results of this research showed that probiotic supplements could reduce the level of FPG (mean difference (MD) = −0.11; 95% CI = −0.15 to −0.04; P=0.0007), serum insulin (MD = −1.68; 95% CI = −2.44 to −0.92; P < 0.00001), insulin resistance (MD = −0.36; 95% CI = −0.53 to −0.20; P < 0.00001), and insulin sensitivity (MD = −21.80; 95% CI = −31.92 to −11.67; P < 0.00001). Regarding the subgroup analysis of different pregnant women, the effects of probiotics on FPG, insulin, and insulin resistance were more obvious among GDM and healthy women than among overweight/obese women. Furthermore, the differences were not significant in HbA1c (MD = −0.05; 95% CI = −0.12 to 0.03; P=0.23), 1 h OGTT (MD = −0.07; 95% CI = −0.25 to 0.10; P=0.42), and 2 h OGTT (MD = −0.03; 95% CI = −0.17 to 0.12; P=0.72). Conclusion This review found that probiotic supplements had certain functions to reduce the level of FPG and improve insulin, insulin resistance, and insulin sensitivity, especially for GDM and healthy pregnant women.
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Loyeau PA, Spotti MJ, Vinderola G, Carrara CR. Encapsulation of potential probiotic and canola oil through emulsification and ionotropic gelation, using protein/polysaccharides Maillard conjugates as emulsifiers. Lebensm Wiss Technol 2021. [DOI: 10.1016/j.lwt.2021.111980] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Diet and Pre-Intervention Washout Modifies the Effects of Probiotics on Gestational Diabetes Mellitus: A Comprehensive Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2021; 13:nu13093045. [PMID: 34578921 PMCID: PMC8465224 DOI: 10.3390/nu13093045] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 12/16/2022] Open
Abstract
Dynamic interactions among gestational diabetes mellitus (GDM), gut microbiota, inflammation, oxidative stress, and probiotics are increasingly acknowledged. This meta-analysis aimed to summarize the effects of probiotics in GDM, focusing on lifestyle intervention and pre-intervention washout, in addition to metabolic, inflammation, oxidative stress, and pregnancy outcomes. Three electronic databases (i.e., PubMed, Scopus, and CENTRAL) were searched from inception until October 2020. A meta-analysis was performed, and the effect sizes were reported as either mean differences or odds ratios with 95% confidence intervals. Altogether, 10 randomized controlled trials enrolling 594 participants were included. The meta-analysis indicated that probiotics supplementation effectively reduced fasting plasma glucose by 3.10 mg/dL, and subgroup analyses suggested that the duration of intervention, number of species, pre-intervention washout period, and dietary intervention may determine the effects of probiotics. Probiotics also reduced the level of inflammatory markers (high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-α, and malondialdehyde), incidence of macrosomia, and newborn hospitalization. In conclusion, this meta-analysis suggests that probiotics may have positive effects on metabolic, inflammation, oxidative stress, and neonatal outcomes in women with GDM. Additionally, diet and pre-intervention washout may modify the effects of probiotics. Future studies are warranted on a larger scale to ascertain the clinical significance.
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Sheyholislami H, Connor KL. Are Probiotics and Prebiotics Safe for Use during Pregnancy and Lactation? A Systematic Review and Meta-Analysis. Nutrients 2021; 13:nu13072382. [PMID: 34371892 PMCID: PMC8308823 DOI: 10.3390/nu13072382] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 12/13/2022] Open
Abstract
Probiotic and prebiotic products have shown potential health benefits, including for the prevention of adverse pregnancy outcomes. The incidence of adverse effects in pregnant people and their infants associated with probiotic/prebiotic/synbiotic intake, however, remains unclear. The objectives of this study were to evaluate the evidence on adverse effects of maternal probiotic, prebiotic, and/or synbiotic supplementation during pregnancy and lactation and interpret the findings to help inform clinical decision-making and care of this population. A systematic review was conducted following PRISMA guidelines. Scientific databases were searched using pre-determined terms, and risk of bias assessments were conducted to determine study quality. Inclusion criteria were English language studies, human studies, access to full-text, and probiotic/prebiotic/synbiotic supplementation to the mother and not the infant. In total, 11/100 eligible studies reported adverse effects and were eligible for inclusion in quantitative analysis, and data were visualised in a GOfER diagram. Probiotic and prebiotic products are safe for use during pregnancy and lactation. One study reported increased risk of vaginal discharge and changes in stool consistency (relative risk [95% CI]: 3.67 [1.04, 13.0]) when administering Lactobacillus rhamnosus and L. reuteri. Adverse effects associated with probiotic and prebiotic use do not pose any serious health concerns to mother or infant. Our findings and knowledge translation visualisations provide healthcare professionals and consumers with information to make evidence-informed decisions about the use of pre- and probiotics.
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Godfrey KM, Barton SJ, El-Heis S, Kenealy T, Nield H, Baker PN, Chong YS, Cutfield W, Chan SY. Myo-Inositol, Probiotics, and Micronutrient Supplementation From Preconception for Glycemia in Pregnancy: NiPPeR International Multicenter Double-Blind Randomized Controlled Trial. Diabetes Care 2021; 44:1091-1099. [PMID: 33782086 PMCID: PMC8132330 DOI: 10.2337/dc20-2515] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 02/10/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Better preconception metabolic and nutritional health are hypothesized to promote gestational normoglycemia and reduce preterm birth, but evidence supporting improved outcomes with nutritional supplementation starting preconception is limited. RESEARCH DESIGN AND METHODS This double-blind randomized controlled trial recruited from the community 1,729 U.K., Singapore, and New Zealand women aged 18-38 years planning conception. We investigated whether a nutritional formulation containing myo-inositol, probiotics, and multiple micronutrients (intervention), compared with a standard micronutrient supplement (control), taken preconception and throughout pregnancy could improve pregnancy outcomes. The primary outcome was combined fasting, 1-h, and 2-h postload glycemia (28 weeks gestation oral glucose tolerance test). RESULTS Between 2015 and 2017, participants were randomized to control (n = 859) or intervention (n = 870); 585 conceived within 1 year and completed the primary outcome (295 intervention, 290 control). In an intention-to-treat analysis adjusting for site, ethnicity, and preconception glycemia with prespecified P < 0.017 for multiplicity, there were no differences in gestational fasting, 1-h, and 2-h glycemia between groups (β [95% CI] loge mmol/L intervention vs. control -0.004 [-0.018 to 0.011], 0.025 [-0.014 to 0.064], 0.040 [0.004-0.077], respectively). Between the intervention and control groups there were no significant differences in gestational diabetes mellitus (24.8% vs. 22.6%, adjusted risk ratio [aRR] 1.22 [0.92-1.62]), birth weight (adjusted β = 0.05 kg [-0.03 to 0.13]), or gestational age at birth (mean 39.3 vs. 39.2 weeks, adjusted β = 0.20 [-0.06 to 0.46]), but there were fewer preterm births (5.8% vs. 9.2%, aRR 0.43 [0.22-0.82]), adjusting for prespecified covariates. CONCLUSIONS Supplementation with myo-inositol, probiotics, and micronutrients preconception and in pregnancy did not lower gestational glycemia but did reduce preterm birth.
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Affiliation(s)
- Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, U.K. .,NIHR Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation Trust, Southampton, U.K
| | - Sheila J Barton
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, U.K
| | - Sarah El-Heis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, U.K
| | - Timothy Kenealy
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Heidi Nield
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, U.K
| | - Philip N Baker
- College of Life Sciences, Biological Sciences and Psychology, University of Leicester, Leicester, U.K
| | - Yap Seng Chong
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Wayne Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start, New Zealand National Science Challenge, Auckland, New Zealand
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Huidrom S. Therapeutic Approach of Probiotics in Children with Atopic Dermatitis. Antiinflamm Antiallergy Agents Med Chem 2021; 20:2-9. [PMID: 31899681 DOI: 10.2174/1871523019666200102110317] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/16/2019] [Accepted: 11/28/2019] [Indexed: 12/13/2022]
Abstract
Pediatric atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease, affecting 20% of children all over the world especially in developed countries. The global prevalence of AD in children has been increasing over recent years. This chronic inflammatory skin disease causes economic and social burden to the family. The exact cause of AD is not known, however recent studies suggest that the imbalance of microflora present in the gut leads to AD. The current treatment of AD involves the application of moisturizer, topical corticosteroids, antihistamines and antibiotics. This line of treatment of AD in children has many side effects. An alternative novel therapeutic approach has to be explored to combat this chronic skin disease. In recent years, there has been increasing interest in the use of probiotics in the modulation of gut microbiota for the management of AD. Many research studies showed that the administration of probiotics gives positive results in the prevention and treatment of AD in children, however, the results are not consistent and conclusive. In this review, the phenomenon that the dysbiosis of the gut flora contributes to the development of AD is addressed and clinical evidence of probiotics in the prevention and treatment of AD children is also summarised.
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Affiliation(s)
- Sangeeta Huidrom
- Department of Pharmacology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun-248001, India
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Effect of Lactobacillus rhamnosus Probiotic in Early Pregnancy on Plasma Conjugated Bile Acids in a Randomised Controlled Trial. Nutrients 2021; 13:nu13010209. [PMID: 33450885 PMCID: PMC7828313 DOI: 10.3390/nu13010209] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/02/2021] [Accepted: 01/09/2021] [Indexed: 01/06/2023] Open
Abstract
We have previously shown that probiotic supplementation with Lactobacillus rhamnosus HN001 (HN001) led to a reduced incidence of gestational diabetes mellitus (GDM). Here we investigate whether HN001 supplementation resulted in alterations in fasting lipids, insulin resistance, or bile acids (BAs) during pregnancy. Fasting plasma samples collected at 24-30 weeks' gestation, from 348 women randomised at 14-16 weeks' gestation to consume daily probiotic HN001 (n = 172) or a placebo (n = 176) were analysed for lipids, insulin, glucose and BAs. Women supplemented with HN001 had lower fasting glucose compared with placebo (p = 0.040), and lower GDM. Significant differences were found in fasting insulin, HOMA-IR, low density lipoprotein-cholesterol (LDL-c), high density lipoprotein (HDL)-c, triglycerides, total cholesterol, and BAs by GDM status. Lower fasting conjugated BAs were seen in women receiving HN001. A significant decrease of glycocholic acid (GCA) was found in older (age ≥ 35) women who received HN001 (p = 0.005), while GDM women showed significant reduced taurodeoxycholic acid (TDCA) (p = 0.018). Fasting conjugated BA was positively correlated with fasting glucose (r = 0.136, p = 0.020) and fasting insulin (r = 0.113, p = 0.036). Probiotic HN001 supplementation decreases conjugated BAs and might play a role in the improvement of glucose metabolism in women with pregnancy.
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Probiotic therapy in couples with infertility: A systematic review. Eur J Obstet Gynecol Reprod Biol 2020; 256:95-100. [PMID: 33188995 DOI: 10.1016/j.ejogrb.2020.10.054] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 10/20/2020] [Accepted: 10/23/2020] [Indexed: 12/12/2022]
Abstract
The reproductive microbiome is becoming increasingly recognised for its influence on fertility. While there has been much work to investigate the treatment of bacterial vaginosis and disordered microbiomes in optimizing outcomes in Assisted Reproductive Technology (ART), the role of routinely prescribed probiotics is yet to be established. The therapeutic potential of probiotic therapy remains an exciting opportunity in ART and this review endeavours to summarise its evidence to date. A systematic review of MEDLINE (Pubmed), Allied Health Literature (CINAHL), EMBASE, Web of Science and the Cochrane database was performed on 7th May 2019, and repeated on 26th August 2019. The search was built using the terms 'subfertility;' 'probiotic therapy;' 'clinical pregnancy rate' and 'assisted reproductive outcomes.' The primary outcome was change in clinical pregnancy rate. Secondary outcomes included improvements in male and female fertility parameters and microbial assessment. The initial search found 882 articles, of which 26 full manuscripts were reviewed. Four articles were eligible for inclusion. Of the two studies that reported the primary outcome, only one study found probiotics increased the clinical pregnancy rate non-significantly (48.0%-58.8%, p = 0.47). It also found higher miscarriage rate (30 % vs 16.6 %, p = 0.47) in the group treated with probiotics. Both studies on males with oral probiotic found significantly improved sperm motility. While benefit in sperm motility has been observed with male probiotic therapy, there is conflicting evidence on the efficacy of probiotic therapy for women undergoing assisted reproduction. High quality randomized studies are needed to definitively examine probiotic therapy and establish its benefit for couples undergoing assisted reproduction.
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Improvement of glucose metabolism in pregnant women through probiotic supplementation depends on gestational diabetes status: meta-analysis. Sci Rep 2020; 10:17796. [PMID: 33082439 PMCID: PMC7576147 DOI: 10.1038/s41598-020-74773-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 10/07/2020] [Indexed: 01/06/2023] Open
Abstract
The aim of this study was to assess the effects of probiotic and synbiotic supplementation on glucose metabolism in pregnant women using data from randomized controlled trials. Furthermore, this meta-analysis examines whether the observed effects depend on the presence or absence of gestational diabetes mellitus (GDM), and if the effect is dependent on the type of supplement used (probiotic or synbiotic). We performed a literature search of databases (Medline, Scopus, Web of Knowledge, and Cochrane Library) and identified all relevant randomized controlled trials (RCTs) published prior to May 2019. We compared the effects of probiotic supplementation with the administration of placebos in pregnant women with and without GDM. The systematic review and meta-analysis protocol were registered in the International Prospective Register of Systematic Reviews as number CRD 42019111467. 1119 study participants from 15 selected studies were included. The participants in four studies did not have GDM (being recruited to the study before week 20 of pregnancy) and the participants in the rest of the studies were diagnosed with GDM between weeks 24 and 28 of gestation. The meta-analysis showed that supplementation lowers serum glucose, insulin levels, and HOMA-IR index, but only in pregnant women with GDM. Moreover, both probiotics and synbiotics lower serum insulin level and HOMA-IR index, but the glucose lowering effect is specific only to probiotics and not synbiotics. Probiotic supplementation may improve glucose metabolism in pregnant women with GDM. There is a need for more RCT studies with larger groups to better estimate this effect.
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Babadi M, Khorshidi A, Aghadavood E, Samimi M, Kavossian E, Bahmani F, Mafi A, Shafabakhsh R, Satari M, Asemi Z. The Effects of Probiotic Supplementation on Genetic and Metabolic Profiles in Patients with Gestational Diabetes Mellitus: a Randomized, Double-Blind, Placebo-Controlled Trial. Probiotics Antimicrob Proteins 2020; 11:1227-1235. [PMID: 30535534 DOI: 10.1007/s12602-018-9490-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This study was carried out to evaluate the effects of probiotic supplementation on genetic and metabolic profiles in patients with gestational diabetes mellitus (GDM) who were not on oral hypoglycemic agents. This randomized, double-blind, placebo-controlled clinical trial was conducted in 48 patients with GDM. Participants were randomly divided into two groups to intake either probiotic capsule containing Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium bifidum, Lactobacillus fermentum (2 × 109 CFU/g each) (n = 24) or placebo (n = 24) for 6 weeks. Probiotic intake upregulated peroxisome proliferator-activated receptor gamma (P = 0.01), transforming growth factor beta (P = 0.002) and vascular endothelial growth factor (P = 0.006), and downregulated gene expression of tumor necrosis factor alpha (P = 0.03) in peripheral blood mononuclear cells of subjects with GDM. In addition, probiotic supplementation significantly decreased fasting plasma glucose (β, - 3.43 mg/dL; 95% CI, - 6.48, - 0.38; P = 0.02), serum insulin levels (β, - 2.29 μIU/mL; 95% CI, - 3.60, - 0.99; P = 0.001), and insulin resistance (β, - 0.67; 95% CI, - 1.05, - 0.29; P = 0.001) and significantly increased insulin sensitivity (β, 0.009; 95% CI, 0.004, 0.01; P = 0.001) compared with the placebo. Additionally, consuming probiotic significantly decreased triglycerides (P = 0.02), VLDL-cholesterol (P = 0.02), and total-/HDL-cholesterol ratio (P = 0.006) and significantly increased HDL-cholesterol levels (P = 0.03) compared with the placebo. Finally, probiotic administration led to a significant reduction in plasma malondialdehyde (P < 0.001), and a significant elevation in plasma nitric oxide (P = 0.01) and total antioxidant capacity (P = 0.01) was observed compared with the placebo. Overall, probiotic supplementation for 6 weeks to patients with GDM had beneficial effects on gene expression related to insulin and inflammation, glycemic control, few lipid profiles, inflammatory markers, and oxidative stress.
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Affiliation(s)
- Mahtab Babadi
- Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Ahmad Khorshidi
- Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
| | - Esmat Aghadavood
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R., Iran
| | - Mansooreh Samimi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Elham Kavossian
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Fereshteh Bahmani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R., Iran
| | - Alireza Mafi
- Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Rana Shafabakhsh
- Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahbobeh Satari
- Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R., Iran.
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Okesene-Gafa KA, Moore AE, Jordan V, McCowan L, Crowther CA. Probiotic treatment for women with gestational diabetes to improve maternal and infant health and well-being. Cochrane Database Syst Rev 2020; 6:CD012970. [PMID: 32575163 PMCID: PMC7386668 DOI: 10.1002/14651858.cd012970.pub2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is carbohydrate intolerance first recognised during pregnancy and associated with complications for mothers and babies. Probiotics are naturally occurring micro-organisms, which when ingested in adequate amounts, may confer health benefits. Evidence of the role of probiotics as treatment for GDM is limited. OBJECTIVES To evaluate the safety and effectiveness of probiotics in treating women with GDM on maternal and infant outcomes. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth's Trials Register ClinicalTrials.gov, WHO International Clinical Trials Registry Platform (ICTRP) (24 July 2019), and reference lists of retrieved studies. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing the use of probiotics versus placebo/standard care for the treatment of GDM. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility, extracted data, checked data accuracy, and assessed risk of bias of included trials. The certainty of evidence for selected maternal and infant/child outcomes was assessed using GRADE. MAIN RESULTS Nine RCTs (695 pregnant women with GDM) comparing probiotics versus placebo were identified. The overall risk of bias in the nine RCTs was low to unclear and the evidence was downgraded for imprecision due to the small numbers of women participating in the trials. The trials were carried out in hospitals and universities in Iran (seven trials), Thailand (one trial) and Ireland (one trial). All trials compared probiotics with placebo. Maternal outcomes We are uncertain if probiotics have any effect compared with placebo on hypertensive disorders of pregnancy, (risk ratio (RR) 1.50, 95% confidence interval (CI) 0.64 to 3.53; participants = 256; studies = 3; low-certainty evidence) and mode of birth as caesareans (average RR 0.64, 95% CI 0.30 to 1.35; participants = 267; studies = 3; low-certainty evidence) because the certainty of evidence is low and the 95% CIs span possible benefit and possible harm. No trials reported primary outcomes of: mode of birth as vaginal/assisted and subsequent development of type 2 diabetes. We are uncertain if probiotics have any effect compared with placebo on induction of labour (RR 1.33, 95% CI 0.74 to 2.37; participants = 127; studies = 1; very low-certainty evidence). For other secondary maternal outcomes, we are uncertain if there are differences between probiotics and placebo for: postpartum haemorrhage; weight gain during pregnancy intervention and total gestational weight gain; fasting plasma glucose and need for extra pharmacotherapy (insulin). Probiotics may be associated with a slight reduction in triglycerides and total cholesterol. In probiotics compared with placebo, there was evidence of reduction in markers for insulin resistance (HOMA-IR) and HOMA-B; and insulin secretion. There was also an increase in quantitative insulin sensitivity check index (QUICKI). Probiotics were associated with minor benefits in relevant bio-markers with evidence of a reduction in inflammatory markers high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and marker of oxidative stress malondialdehyde; and an increase in antioxidant total glutathione, but we are uncertain if there is any difference in total antioxidant capacity. No trials reported secondary outcomes: perineal trauma, postnatal weight retention or return to pre-pregnancy weight and postnatal depression. Infant/child/adult outcomes We are uncertain if probiotics have any effect, compared with placebo, on the risk of large-for-gestational-age babies (RR 0.73, 95% CI 0.35 to 1.52; participants = 174; studies = 2; low-certainty evidence) or infant hypoglycaemia (RR 0.85, 95% CI 0.39 to 1.84; participants = 177; studies = 3; low-certainty evidence) because the certainty of evidence is low and the 95% CIs span possible benefit and possible harm. No trials reported primary outcomes of: perinatal (fetal/neonatal) mortality; or neurosensory disability. For other secondary outcomes, we are uncertain if there is any difference between probiotics and placebo in gestational age at birth, preterm birth, macrosomia, birthweight, head circumference, length, infant hypoglycaemia, and neonatal intensive care unit (NICU) admissions. There was evidence of a reduction in infant hyperbilirubinaemia with probiotics compared with placebo. No trials reported secondary outcomes: infant adiposity, and later childhood adiposity. There were no adverse events reported by any of the trials. AUTHORS' CONCLUSIONS Low-certainty evidence means we are not certain if there is any difference between probiotic and placebo groups in maternal hypertensive disorders of pregnancy, caesareans; and large-for-gestational-age babies. There were no adverse events reported by the trials. Due to the variability of probiotics used and small sample sizes of trials, evidence from this review has limited ability to inform practice. Well-designed adequately-powered trials are needed to identify whether probiotics may improve maternal blood glucose levels and/or infant/child/adult outcomes; and whether they can be used to treat GDM.
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Affiliation(s)
- Karaponi Am Okesene-Gafa
- Department of Obstetrics and Gynecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Abigail E Moore
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Vanessa Jordan
- Cochrane New Zealand, Department Obstetrics and Gynecology, University of Auckland, Auckland, New Zealand
| | - Lesley McCowan
- Department of Obstetrics and Gynaecology, School of Population Health, University of Auckland, Auckland, New Zealand
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Masulli M, Vitacolonna E, Fraticelli F, Della Pepa G, Mannucci E, Monami M. Effects of probiotic supplementation during pregnancy on metabolic outcomes: A systematic review and meta-analysis of randomized controlled trials. Diabetes Res Clin Pract 2020; 162:108111. [PMID: 32194215 DOI: 10.1016/j.diabres.2020.108111] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/13/2020] [Accepted: 03/02/2020] [Indexed: 01/06/2023]
Abstract
AIM To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of probiotics in pregnancy on the incidence of gestational diabetes (GDM) and fasting plasma glucose (FPG). METHODS A MEDLINE, EMBASE, Scopus and Cochrane search (up to May 30th, 2019) was performed to identify RCTs of comparison of probiotics with placebo/active comparators in pregnant women. Principal endpoints were the incidence of GDM and the change of FPG. Other maternal and fetal outcomes were secondary endpoints. Mantel-Haenszel Odds Ratio with 95% CI (MH-OR) was calculated for dichotomous outcomes, whereas standardized differences in means was calculated for continuous variables. (PROSPERO registration CRD42019139889). FINDINGS A total of 17 RCTs, all versus placebo, was identified. The overall quality of the trials was satisfactory. No effect of probiotics on incidence of GDM (MH-OR: 0.77[0.51,1.16], p = 0.21,I2:62%) was observed, with a small but significant reduction of FPG (mean difference -1.01 [-1.96, -0.06]mg/dl, p = 0.02, I2:46%). Among secondary endpoints, a significant reduction of maternal insulin (both in women with or without diabetes) was observed in the probiotics group. INTERPRETATION Probiotics during pregnancy do not reduce the incidence of GDM, with a very little (statistically but not clinically significant) reduction of fasting plasma glucose.
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Affiliation(s)
- Maria Masulli
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Italy.
| | - Ester Vitacolonna
- Department of Medicine and Aging, School of Medicine and Health Sciences, "G. d'Annunzio" University, Chieti, Pescara, Italy
| | - Federica Fraticelli
- Department of Medicine and Aging, School of Medicine and Health Sciences, "G. d'Annunzio" University, Chieti, Pescara, Italy
| | - Giuseppe Della Pepa
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Italy
| | | | - Matteo Monami
- Diabetology, Careggi Hospital and University of Florence, Italy
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Mechanistic insights into the action of probiotics against bacterial vaginosis and its mediated preterm birth: An overview. Microb Pathog 2020; 141:104029. [PMID: 32014462 DOI: 10.1016/j.micpath.2020.104029] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/29/2020] [Indexed: 02/07/2023]
Abstract
The human body is a reservoir of numerous micro-creatures; whose role is substantial and indispensable in the overall development of human beings. The advances in omic approaches have offered powerful means to decipher the core microbiome and metabolome diversities in a specific organ system. The establishment of lactobacilli in the female reproductive tract is thought to be a paramount prerequisite that maintains homeostatic conditions for a sustainable and healthy pregnancy. Nevertheless, a plethora of such Lactobacillus strains of vaginal source revealed probiotic phenotypes. The plummeting in the occurrence of lactobacilli in the vaginal ecosystem is associated with several adverse pregnancy outcomes (APOs). One such pathological condition is "Bacterial Vaginosis" (BV), a pathogen dominated gynecological threat. In this scenario, the ascending traffic of notorious Gram-negative/variable BV pathogens to the uterus is one of the proposed pathways that give rise to inflammation-related APOs like preterm birth. Since antibiotic resistance is aggravating among urogenital pathogens, the probiotics intervention remains one of the alternative biotherapeutic strategies to overcome BV and its associated APOs. Perhaps, the increased inclination towards the safer and natural biotherapeutic strategies rather than pharmaceutical drugs for maintaining gestational and reproductive health resulted in the use of probiotics in pregnancy diets. In this context, the current review is an attempt to highlight the microbiome and metabolites signatures of BV and non-BV vaginal ecosystem, inflammation or infection-related preterm birth, host-microbial interactions, role and effectiveness of probiotics to fight against aforesaid diseased conditions.
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Dunn AB, Hanson L, VandeVusse L, Leslie S. Through the Microbial Looking Glass: Premature Labor, Preeclampsia, and Gestational Diabetes: A Scoping Review. J Perinat Neonatal Nurs 2019; 33:35-51. [PMID: 30676461 PMCID: PMC6349420 DOI: 10.1097/jpn.0000000000000375] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The influence of microbial factors on adverse perinatal outcomes has become the focal point of recent investigations, with particular interest in the role of the microbiome and probiotic interventions. The purpose of this scoping review was to identify and critique the most recent evidence about these factors as they relate to pregnancies complicated by preeclampsia (PEC), preterm birth (PTB), and gestational diabetes mellitus (GDM). Four databases (PubMed, EMBASE, Web of Science, and Cochrane) were searched for articles published in English in the last 10 years with the concepts of the microbiome, probiotics, and PEC, PTB, or GDM. Forty-nine articles were eligible for full-text review. Five articles were excluded, leaving 44 articles that met all the eligibility criteria. The relationships between the microbiome and the risk for PEC, PTB, and GDM are not fully elucidated, although probiotic interventions seem beneficial in decreasing PEC and GDM risk. Probiotic interventions targeting bacterial vaginosis and elimination of infection in women at risk for PTB appear to be beneficial. More research is needed to understand the contributions of the microbiome to adverse perinatal outcomes. Probiotic interventions appear to be effective in reducing risk for select outcomes.
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Affiliation(s)
- Alexis B Dunn
- Nell Hodgson Woodruff School of Nursing at Emory University, Atlanta, Georgia (Dr Dunn); Nurse-Midwifery Program at the Marquette University College of Nursing, Milwaukee, Wisconsin (Dr Hanson); Marquette University College of Nursing, Milwaukee, Wisconsin (Dr VandeVusse); and Woodruff Health Sciences Center Library at Emory University, Atlanta, Georgia (Ms Leslie)
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Effects of probiotics on blood glucose, biomarkers of inflammation and oxidative stress in pregnant women with gestational diabetes mellitus: A meta-analysis of randomized controlled trials. Med Clin (Barc) 2019; 154:199-206. [PMID: 31630848 DOI: 10.1016/j.medcli.2019.05.041] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/16/2019] [Accepted: 05/23/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND The role of probiotics supplementation in gestational diabetes mellitus (GDM) remains controversial. We conducted this meta-analysis to investigate the effects of probiotics on fasting blood glucose (FBG), high-sensitivity C-reactive protein (hs-CRP), total glutathione (GSH), malonaldehyde (MDA) and nitric oxide (NO) levels in pregnant women with GDM. METHODS We systematically searched the Cochrane Library, Embase and PubMed electronic databases up to November 2018. A meta-analysis was then conducted using weighted mean difference (WMD) and 95% confidence interval (CI) as effect measures. RESULTS A total of 7 studies were enrolled in the final meta-analysis. Data showed that probiotics reduced FBG (WMD: -3.19mg/dl, 95% CI: -5.55 to -0.82, P=0.008) in pregnant women with GDM. Sub-group analysis suggested that the effect of probiotics on lowering FBG was more significant in patients with a baseline FBG ≥92mg/dl (WMD: -3.62mg/dl, 95% CI: -6.64 to -0.60, P=0.019), a duration of probiotic treatment ≤6 weeks (WMD: -3.24mg/dl, 95% CI: -4.96 to -1.53, P=0.000) and a dose<6×109 colony-forming unit (CFU) (WMD: -3.37mg/dl, 95% CI: -6.64 to -0.10, P=0.043). In addition, probiotics were effective in reducing hs-CRP and MDA in pregnant women with GDM, but had no significant effect on either GSH or NO. CONCLUSION This meta-analysis suggests that probiotics supplementation might have a small effect on the reduction of FBG in pregnant women with GDM, and might have certain effects on some biomarkers of inflammation and oxidative stress. However, given the heterogeneity between studies, the results should be interpreted with caution but are worthy of further investigation.
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Vallianou N, Stratigou T, Christodoulatos GS, Dalamaga M. Understanding the Role of the Gut Microbiome and Microbial Metabolites in Obesity and Obesity-Associated Metabolic Disorders: Current Evidence and Perspectives. Curr Obes Rep 2019; 8:317-332. [PMID: 31175629 DOI: 10.1007/s13679-019-00352-2] [Citation(s) in RCA: 180] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE In this review, we summarize current evidence on the gut microbiome and microbial metabolites in relation to obesity and obesity-associated metabolic disorders. Special emphasis is given on mechanisms interconnecting gut microbiome and microbial metabolites with metabolic disorders as well as on potential preventive and therapeutic perspectives with a "bench to bedside" approach. RECENT FINDINGS Recent data have highlighted the role of gut dysbiosis in the etiology and pathogenesis of metabolic disorders, including obesity, metabolic syndrome, type 2 diabetes mellitus, and non-alcoholic fatty liver disease. Overall, most studies have demonstrated a reduction in gut microbiome diversity and richness in obese subjects, but there is still much debate on the exact microbial signature of a healthy or an obese gut microbiome. Despite the controversial role of an altered gut microbiome as a cause or consequence of obesity in human studies, numerous animal studies and certain human studies suggest beneficial metabolic effects of certain microbial intestinal metabolites, such as butyrate, that could be used in the prevention and treatment of obesity and its comorbidities. More randomized controlled trials and larger prospective studies including well-defined cohorts as well as a multi-omics approach are warranted to better identify the associations between the gut microbiome, microbial metabolites, and obesity and its metabolic complications.
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Affiliation(s)
- Natalia Vallianou
- Department of Endocrinology, Evangelismos General Hospital of Athens, 45-47 Ypsilantou street, 10676, Athens, Greece
| | - Theodora Stratigou
- Department of Endocrinology, Evangelismos General Hospital of Athens, 45-47 Ypsilantou street, 10676, Athens, Greece
| | - Gerasimos Socrates Christodoulatos
- Laboratory of Microbiology, KAT Hospital, 2 Nikis, Kifisia, 14561, Athens, Greece
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Mikras Asias #27, 75 Mikras Asias, Goudi, 11527, Athens, Greece
| | - Maria Dalamaga
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Mikras Asias #27, 75 Mikras Asias, Goudi, 11527, Athens, Greece.
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Okesene-Gafa KA, Li M, McKinlay CJ, Taylor RS, Rush EC, Wall CR, Wilson J, Murphy R, Taylor R, Thompson JM, Crowther CA, McCowan LM. Effect of antenatal dietary interventions in maternal obesity on pregnancy weight-gain and birthweight: Healthy Mums and Babies (HUMBA) randomized trial. Am J Obstet Gynecol 2019; 221:152.e1-152.e13. [PMID: 30878323 DOI: 10.1016/j.ajog.2019.03.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 02/28/2019] [Accepted: 03/07/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Pregnancy interventions that improve maternal and infant outcomes are urgently needed in populations with high rates of obesity. We undertook the Healthy Mums and Babies (HUMBA) randomized controlled trial to assess the effect of dietary interventions and or probiotics in a multiethnic population of pregnant women with obesity, living in an area of high deprivation. OBJECTIVES To determine whether a culturally tailored dietary intervention and or daily probiotic capsules in pregnant women with obesity reduces the co-primary outcomes of (1) excessive gestational weight gain (mean >0.27 kg/week) and (2) birthweight. STUDY DESIGN We conducted a 2 × 2 factorial, randomized controlled trial in women without diabetes at pregnancy booking, body mass index ≥30 kg/m2, and a singleton pregnancy. At 12+0 to 17+6 weeks' gestation, eligible women were randomized to a dietary intervention (4 tailored educational sessions at ≤28 weeks' gestation by a community health worker trained in key aspects of pregnancy nutrition plus text messaging until birth) or to routine dietary advice; and to daily capsules containing either (Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12, minimum 6.5 × 109 colony forming units), or placebo, until birth. Analysis was by intention to treat with adjustment for maternal baseline body mass index. Infant outcomes were additionally adjusted for ethnicity, sex, and gestational age at birth. RESULTS In total, 230 women were recruited between April 2015 and June 2017 (dietary intervention N = 116 vs routine dietary advice N = 114; probiotics N = 115 vs placebo N = 115). Baseline characteristics and demographic variables were similar across all groups. There was no significant difference between intervention groups, for the co-primary outcomes of (1) proportion of women with excessive gestational weight gain (dietary intervention vs routine advice: 79/107 [73.8%] vs 90/110 [81.8%], adjusted relative risk [relative risk, 0.92; 95% confidence interval, 0.80-1.05]; probiotics versus placebo: 89/108 [82.4%] and 80/109 [73.4%], relative risk, 1.14, 95% confidence interval, 0.99-1.31) or (2) birthweight (dietary intervention vs routine advice: 3575 vs 3612 g, adjusted mean difference, -24 g, 95% confidence interval, -146 to 97; probiotics vs placebo: 3685 vs 3504 g, adjusted mean difference, 107 g, 95% confidence interval, -14 to 228). Total maternal weight gain, a secondary outcome, was lower with dietary intervention compared with routine dietary advice (9.7 vs 11.4 kg, adjusted mean difference, -1.76, 95% confidence interval, -3.55 to 0.03). There were no significant differences between intervention groups in other secondary maternal or neonatal outcomes. CONCLUSION Although dietary education and or probiotics did not alter rates of excessive gestational weight gain or birthweight in this multiethnic, high-deprivation population of pregnant women with obesity, dietary education was associated with a modest reduction in total weight gain with potential future benefit for the health of mothers and their offspring if sustained.
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McIntyre HD, Catalano P, Zhang C, Desoye G, Mathiesen ER, Damm P. Gestational diabetes mellitus. Nat Rev Dis Primers 2019; 5:47. [PMID: 31296866 DOI: 10.1038/s41572-019-0098-8] [Citation(s) in RCA: 956] [Impact Index Per Article: 159.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/29/2019] [Indexed: 12/11/2022]
Abstract
Hyperglycaemia that develops during pregnancy and resolves after birth has been recognized for over 50 years, but uniform worldwide consensus is lacking about threshold hyperglycaemic levels that merit a diagnosis of 'gestational diabetes mellitus' (GDM) and thus treatment during pregnancy. GDM is currently the most common medical complication of pregnancy, and prevalence of undiagnosed hyperglycaemia and even overt diabetes in young women is increasing. Maternal overweight and obesity, later age at childbearing, previous history of GDM, family history of type 2 diabetes mellitus and ethnicity are major GDM risk factors. Diagnosis is usually performed using an oral glucose tolerance test (OGTT), although a non-fasting, glucose challenge test (GCT) is used in some parts of the world to screen women for those requiring a full OGTT. Dietary modification and increased physical activity are the primary treatments for GDM, but pharmacotherapy, usually insulin, is used when normoglycaemia is not achieved. Oral hypoglycaemic agents, principally metformin and glibenclamide (glyburide), are also used in some countries. Treatment improves immediate pregnancy outcomes, reducing excess fetal growth and adiposity and pregnancy-related hypertensive disorders. GDM increases the risk of long-term complications, including obesity, impaired glucose metabolism and cardiovascular disease, in both the mother and infant. Optimal management of mother and infant during long-term follow-up remains challenging, with very limited implementation of preventive strategies in most parts of the world.
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Affiliation(s)
- H David McIntyre
- Mater Research and University of Queensland, Brisbane, Queensland, Australia.
| | - Patrick Catalano
- Mother Infant Research Institute, Department of Obstetrics and Gynecology, Tufts University School of Medicine, Friedman School of Nutrition Science and Policy, Boston, MA, USA
| | - Cuilin Zhang
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, USA
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Elisabeth R Mathiesen
- Department of Endocrinology, Center for Pregnant Women with Diabetes, Rigshospitalet and The Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter Damm
- Department of Obstetrics, Center for Pregnant Women with Diabetes, Rigshospitalet and The Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Rusu E, Enache G, Cursaru R, Alexescu A, Radu R, Onila O, Cavallioti T, Rusu F, Posea M, Jinga M, Radulian G. Prebiotics and probiotics in atopic dermatitis. Exp Ther Med 2019; 18:926-931. [PMID: 31384325 DOI: 10.3892/etm.2019.7678] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 03/01/2019] [Indexed: 12/13/2022] Open
Abstract
Recent years have brought additional data on the benefits of prebiotics and probiotics treatment in patients with atopic dermatitis. This review includes all the articles published in PubMed, Scopus, Embase and Cochrane databases until 05.06.2018. The terms used for the search were 'prebiotic', 'probiotic', 'atopic dermatitis', 'Severity Scoring of Atopic Dermatitis', and 'SCORAD'. There was an increase of the intestinal permeability reported in patients with atopic dermatitis and a reduction of the cutaneous microbiome diversity. Probiotics modulate the general microbiome and immune status by improving the intestinal barrier; these effects can be responsible for reducing allergic phenomenon and atopic dermatitis severity. We have structured the results by age groups as infants, 1-18 years, adults, and also pregnancy and lactation. Literature does not offer yet answers on the issues such as the optimal dosing, duration needed to see beneficial effects, the optimal time to start the treatment; the personalized use of probiotics according to colonic dysbiosis may be associated with better results. However, most randomized controlled trials and meta-analyzes support the administration of probiotics for at least 8 weeks in order to obtain beneficial effects in improving severity scoring of atopic dermatitis.
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Affiliation(s)
- Emilia Rusu
- Department 2 Infectious Diseases, Epidemiology, Microbiology, Parasitology, Virology, Diabetes, Endocrinology, 'Carol Davila' University of Medicine and Farmacy, 010458 Bucharest, Romania
| | - Georgiana Enache
- Department 2 Infectious Diseases, Epidemiology, Microbiology, Parasitology, Virology, Diabetes, Endocrinology, 'Carol Davila' University of Medicine and Farmacy, 010458 Bucharest, Romania.,Department of Diabetes, Nutrition and Metabolic Diseases, 'Dr. Pompei Samarian' County Emergency Hospital, 910071 Calarasi, Romania
| | - Raluca Cursaru
- Department 2 Infectious Diseases, Epidemiology, Microbiology, Parasitology, Virology, Diabetes, Endocrinology, 'Carol Davila' University of Medicine and Farmacy, 010458 Bucharest, Romania
| | - Alexandra Alexescu
- Department 2 Infectious Diseases, Epidemiology, Microbiology, Parasitology, Virology, Diabetes, Endocrinology, 'Carol Davila' University of Medicine and Farmacy, 010458 Bucharest, Romania
| | - Raluca Radu
- Department 2 Infectious Diseases, Epidemiology, Microbiology, Parasitology, Virology, Diabetes, Endocrinology, 'Carol Davila' University of Medicine and Farmacy, 010458 Bucharest, Romania
| | - Oana Onila
- Department 2 Infectious Diseases, Epidemiology, Microbiology, Parasitology, Virology, Diabetes, Endocrinology, 'Carol Davila' University of Medicine and Farmacy, 010458 Bucharest, Romania
| | - Teodora Cavallioti
- Department 2 Infectious Diseases, Epidemiology, Microbiology, Parasitology, Virology, Diabetes, Endocrinology, 'Carol Davila' University of Medicine and Farmacy, 010458 Bucharest, Romania
| | - Florin Rusu
- Department of Urology, 'Dr. Carol Davila' Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Mihaela Posea
- Department of Diabetes, Nutrition and Metabolic Diseases, Smart Nutrition Clinic, 051075 Bucharest, Romania
| | - Mariana Jinga
- Department of Gastroenterology, 'Dr. Carol Davila' Central Military Emergency University Hospital, 051075 Bucharest, Romania
| | - Gabriela Radulian
- Department 2 Infectious Diseases, Epidemiology, Microbiology, Parasitology, Virology, Diabetes, Endocrinology, 'Carol Davila' University of Medicine and Farmacy, 010458 Bucharest, Romania
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Kumbhare SV, Patangia DVV, Patil RH, Shouche YS, Patil NP. Factors influencing the gut microbiome in children: from infancy to childhood. J Biosci 2019; 44:49. [PMID: 31180062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The human microbiota plays a crucial role in educating the immune system and influencing host health right since birth. Various maternal factors along with the vertical microbial transfer from the mother, as well as the horizontal environmental transmission and internal factors relating to the infant, play a crucial role in modulating the gut microbiota. The early life microflora is highly unstable and undergoes dynamic changes during the first few years, converging towards a more stabilized adult microbiota by co-evolving with the host by the age of 3-4 years. Microbiota studies have underlined the role of dysbiosis in developing several metabolic disorders like obesity, diabetes and immune-related disorders like asthma, to name a few. Thus, understanding early life microbial composition and various factors affecting the microbial community will provide a platform for developing strategies/techniques to maintain host health by restoring gut microbial flora. This review focuses on the factors that affect the microbial composition of the foetus in utero, during birth, infancy through childhood.
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Affiliation(s)
- Shreyas V Kumbhare
- National Centre for Cell Science, Savitribai Phule University of Pune Campus, Pune, Maharashtra 411007, India
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Abstract
Gestational and pre-gestational diabetes are frequent problems encountered in obstetrical practice and their complications may influence both the mother (such as hypertension, pre-eclampsia, increased caesarean rates) and the foetus (such as macrosomia, shoulder dystocia, respiratory distress, hypoglycaemia, or childhood obesity and diabetes). Given the important implications for mothers and their offspring, screening and appropriate management of diabetes during pregnancy are essential. This is a review of articles published between 2015 and 2018 on Medline via Ovid that focus on advances in the management of diabetes in pregnancy. Recent data have concentrated predominantly on optimising glycaemic control, which is key for minimising the burden of maternal and foetal complications. Lifestyle changes, notably physical exercise and diet adjustments, appear to have beneficial effects. However, data are inconclusive with respect to which diet and form of exercise provide optimal benefits. Oral glycaemic agents-in particular, metformin-are gaining acceptance as more data indicating their long-term safety for the foetus and newborn emerge. Recent reviews present inconclusive data on the efficacy and safety of insulin analogues. New technologies such as continuous insulin pumps for type 1 diabetes and telemedicine-guided management of diabetes are significantly appreciated by patients and represent promising clinical tools. There are few new data addressing the areas of antenatal foetal surveillance, the timing and need for induction of delivery, and the indications for planned caesarean section birth.
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Affiliation(s)
- Cristina Mitric
- Obstetrics & Gynaecology, McGill University, Montreal, Quebec, H4A 3J1, Canada
| | - Jade Desilets
- Obstetrics & Gynaecology, McGill University, Montreal, Quebec, H4A 3J1, Canada
| | - Richard N Brown
- Obstetrics & Gynaecology, McGill University, Montreal, Quebec, H4A 3J1, Canada
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Asgharian H, Homayouni-Rad A, Mirghafourvand M, Mohammad-Alizadeh-Charandabi S. Effect of probiotic yoghurt on plasma glucose in overweight and obese pregnant women: a randomized controlled clinical trial. Eur J Nutr 2019; 59:205-215. [PMID: 31069459 DOI: 10.1007/s00394-019-01900-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 01/01/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION There is only some evidence about effectiveness of probiotics for preventing gestational hyperglycaemia. This trial examined the effects of probiotic yoghurts containing Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 on maternal plasma glucose (primary outcome) and on some maternal and infant complications (secondary outcomes) in overweight and obese women with no diabetes in pregnancy. METHODS Using stratified block randomization, women with pre- or early-pregnancy BMI ≥ 25 and fasting plasma glucose < 92 mg/dl at 22 weeks of gestation were assigned into probiotic or conventional yoghurt group, consuming 100 g/day from 24 weeks of gestation until delivery. The women and their infants were followed up until 1 month after birth. RESULTS In each group, one out of 65 women had intra-uterine foetal death and were not analysed for other outcomes. The mean BMI was 29.2 (SD 3.3) in probiotic and 30.3 (SD 4.1) in conventional yoghurt group. Four weeks after initiation of the treatment, plasma glucose levels were significantly lower in the probiotic than in conventional yoghurt group at fasting (mean difference adjusted for the BMI category) and baseline FPG (- 4.0 mg/dl; 95% confidence interval - 6.9, - 1.1) and 2-h OGTT (- 13.9; - 22.8, - 5.0). At the 1-h OGTT, however, the difference was not statistically significant (- 9.8; - 20.6, 0.9). Further, there was a significantly lower infant bilirubin level in the probiotic group on days 3-5 after birth (- 2.2 mg/dl; - 3.3, - 1.2). There were not statistically significant differences between the groups regarding the risk of gestational diabetes (6 vs 11; odds ratio 0.5; 0.2, 1.5), preterm delivery (3 vs 8; 0.3; 0.1, 1.2), and other maternal and infant outcomes. CONCLUSION The probiotics supplementation has some beneficial effects on glucose metabolism of overweight and obese pregnant women. Nevertheless, further studies are required to judge the clinical significance of such effects.
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Affiliation(s)
- Hanieh Asgharian
- Students' Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR, Iran
| | - Aziz Homayouni-Rad
- Department of Food Science and Technology, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, IR, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR, Iran
| | - Sakineh Mohammad-Alizadeh-Charandabi
- Research Center for Evidence-Based Medicine, Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Shariatie Ave., P.O. Box: 51745-347, Tabriz, IR, 513897977, Iran.
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47
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Callaway LK, McIntyre HD, Barrett HL, Foxcroft K, Tremellen A, Lingwood BE, Tobin JM, Wilkinson S, Kothari A, Morrison M, O'Rourke P, Pelecanos A, Dekker Nitert M. Probiotics for the Prevention of Gestational Diabetes Mellitus in Overweight and Obese Women: Findings From the SPRING Double-Blind Randomized Controlled Trial. Diabetes Care 2019; 42:364-371. [PMID: 30659070 DOI: 10.2337/dc18-2248] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 12/17/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Given the role of gut microbiota in regulating metabolism, probiotics administered during pregnancy might prevent gestational diabetes mellitus (GDM). This question has not previously been studied in high-risk overweight and obese pregnant women. We aimed to determine whether probiotics (Lactobacillus rhamnosus and Bifidobacterium animalis subspecies lactis) administered from the second trimester in overweight and obese women prevent GDM as assessed by an oral glucose tolerance test (OGTT) at 28 weeks' gestation. Secondary outcomes included maternal and neonatal complications, maternal blood pressure and BMI, and infant body composition. RESEARCH DESIGN AND METHODS This was a double-blind randomized controlled trial of probiotic versus placebo in overweight and obese pregnant women in Brisbane, Australia. RESULTS The study was completed in 411 women. GDM occurred in 12.3% (25 of 204) in the placebo arm and 18.4% (38 of 207) in the probiotics arm (P = 0.10). At OGTT, mean fasting glucose was higher in women randomized to probiotics (79.3 mg/dL) compared with placebo (77.5 mg/dL) (P = 0.049). One- and two-hour glucose measures were similar. Preeclampsia occurred in 9.2% of women randomized to probiotics compared with 4.9% in the placebo arm (P = 0.09). Excessive weight gain occurred in 32.5% of women in the probiotics arm (55 of 169) compared with 46% in the placebo arm (81 of 176) (P = 0.01). Rates of small for gestational age (<10th percentile) were 2.4% in the probiotics arm (5 of 205) and 6.5% in the placebo arm (13 of 199) (P = 0.042). There were no differences in other secondary outcomes. CONCLUSIONS The probiotics used in this study did not prevent GDM in overweight and obese pregnant women.
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Affiliation(s)
- Leonie K Callaway
- Women's and Newborn Services, Royal Brisbane and Women's Hospital, Herston, Australia .,Faculty of Medicine, The University of Queensland, Herston, Australia
| | - H David McIntyre
- Faculty of Medicine, The University of Queensland, Herston, Australia.,Mater Medical Research Institute, South Brisbane, Australia
| | - Helen L Barrett
- Faculty of Medicine, The University of Queensland, Herston, Australia.,Mater Medical Research Institute, South Brisbane, Australia
| | - Katie Foxcroft
- Women's and Newborn Services, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Anne Tremellen
- Mater Medical Research Institute, South Brisbane, Australia
| | | | | | - Shelley Wilkinson
- Mater Medical Research Institute, South Brisbane, Australia.,Department of Nutrition and Dietetics, Mater Group, South Brisbane, Australia
| | | | - Mark Morrison
- Faculty of Medicine, University of Queensland Diamantina Institute, Translational Research Institute, Woolloongabba, Australia
| | - Peter O'Rourke
- QIMR Berghofer Medical Research Institute, Herston, Australia
| | - Anita Pelecanos
- QIMR Berghofer Medical Research Institute, Herston, Australia
| | - Marloes Dekker Nitert
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Australia
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Han MM, Sun JF, Su XH, Peng YF, Goyal H, Wu CH, Zhu XY, Li L. Probiotics improve glucose and lipid metabolism in pregnant women: a meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:99. [PMID: 31019949 DOI: 10.21037/atm.2019.01.61] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background This study aims to assess the effects of probiotic supplementation on the maternal metabolism and the risk of development of gestational diabetes mellitus (GDM) in the pregnant women by a meta-analysis of relevant randomized controlled trials (RCTs). Methods The medical literature was searched from PubMed, Web of Science and the Cochrane Library since inception to October 2017. Two investigators independently performed the data extraction and quality assessment. The mean differences (MD) or standardized mean differences (SMD) or relative risk (RR) with 95% confidence intervals (CIs) were calculated with the random-effects model. Results From 648 citations, a total of ten RCTs published in 13 articles with 1,139 participants met the inclusion criteria. The meta-analysis showed that probiotics supplementation effectively reduced the fasting blood glucose (FBG) levels (MD -0.11 mmol/L, P=0.0003), serum insulin levels (MD -2.06 µU/mL, P<0.00001), insulin resistance (HOMA-IR) (MD -0.38, P<0.00001). The study found a significant effect of probiotics on decreasing the risk of GDM [risk ratio (RR) 0.52, P=0.003) in early pregnancy. Additionally, there were statistically significant reductions in the total cholesterol and triglycerides levels after probiotic interventions (SMD -0.56, P=0.03; SMD -0.66, P=0.04), respectively. Conclusions Our study shows that the probiotic use was associated with improved glucose and lipid metabolism in the pregnant women, and might also contribute to the reduced risk of GDM.
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Affiliation(s)
- Man-Man Han
- Department of Endocrinology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China.,Pancreatic Research Institute, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Jin-Fang Sun
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Xiang-Hui Su
- Department of Endocrinology, the First Affiliated Hospital of the Medical College, Shihezi University, Shihezi 832003, China
| | - You-Fan Peng
- Department of Endocrinology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China.,Pancreatic Research Institute, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Hemant Goyal
- Department of Internal Medicine, School of Medicine, Mercer University, Macon, USA
| | - Chun-Hua Wu
- Department of General medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Xiang-Yun Zhu
- Department of Endocrinology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China.,Pancreatic Research Institute, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Ling Li
- Department of Endocrinology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China.,Pancreatic Research Institute, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
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Kooshki A, Tofighiyan T, Miri M. A synbiotic supplement for inflammation and oxidative stress and lipid abnormalities in hemodialysis patients. Hemodial Int 2019; 23:254-260. [DOI: 10.1111/hdi.12748] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 02/11/2019] [Accepted: 02/12/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Akram Kooshki
- Traditional and Complementary Medicine Center, Department of Nutrition & Biochemistry, School of MedicineSabzevar University of Medical Sciences Sabzevar Iran
| | - Tahereh Tofighiyan
- Department of Nursing, School of Nursing and MidwiferySabzevar University of Medical Sciences Sabzevar Iran
| | - Mohammad Miri
- Cellular and Molecular Research Center, Department of Environmental Health Engineering, School of Public HealthSabzevar University of Medical Sciences Sabzevar Iran
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50
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Zhang J, Ma S, Wu S, Guo C, Long S, Tan H. Effects of Probiotic Supplement in Pregnant Women with Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Diabetes Res 2019; 2019:5364730. [PMID: 31583250 PMCID: PMC6748202 DOI: 10.1155/2019/5364730] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/11/2019] [Accepted: 08/07/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Previous studies showed that probiotics could improve glycemic control and attenuate some of the adverse effects of type 2 diabetes. However, whether the effects are generalizable to gestational diabetes mellitus (GDM) remains uncertain. OBJECTIVE We conducted a systematic review and meta-analysis to evaluate the effects of probiotic supplement in GDM. METHOD PubMed, EMBASE, the Cochrane Library, and EBSCO were systematically searched for relevant literature published through January 2019. Randomized controlled trials (RCTs) assessing the effects of probiotic supplement on one or more of the following in GDM were included: pregnancy outcome (the primary outcome), glycemic control, blood lipid profile, and inflammation and oxidative stress. Two reviewers independently extracted data and assessed the risk of bias in studies. Meta-analysis was conducted by using the fixed effects model unless substantial heterogeneity was found among studies. RESULTS Eleven randomized trials involving 719 participants were included for analysis. Eight of the trials were from Iran. Probiotics were given alone in eight trials and synbiotics in three trials. Though the components of probiotics varied, Lactobacillus was included in all trials and Bifidobacterium in all except one. The duration of intervention ranged from 4 to 8 weeks. Almost all trials (10/11) had a low risk of bias. Probiotic supplementation reduced the risk of a newborn's hyperbilirubinemia by 74% and improved four biomarkers for glycemic control (fasting blood glucose, fasting serum insulin, homeostasis model assessment insulin resistance, and quantitative insulin sensitivity check index), two biomarkers for lipid profile (triglycerides and HDL-cholesterol), and four biomarkers for inflammation and oxidative stress (total glutathione, malondialdehyde, nitric oxide, and total antioxidant capacity). But significant heterogeneity was observed in the meta-analyses on the four biomarkers related to glycemic control and on triglycerides, which could not be explained by prespecified subgroup analyses according to the mean age of participants and intervention type (i.e., probiotics or synbiotics). The effects on the risk of preterm delivery, macrosomia and a newborns' hypoglycemia, gestational age, total cholesterol, and LDL-cholesterol were not statistically significant. CONCLUSION Probiotic supplementation seemed to be able to reduce the risk of a newborn's hyperbilirubinemia and improve glycemic control, blood lipid profiles and inflammation and oxidative stress in pregnant women with GDM. However, due to the heterogeneity among existing studies, the surrogate nature of outcomes, and/or the fact that most studies were from Iran, the clinical significance and generalizability of the above findings remain uncertain. Further studies are warranted to address the limitations of existing evidence and better inform the management of GDM.
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Affiliation(s)
- Jiayue Zhang
- Department of Epidemiology and Biostatistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Shujuan Ma
- Department of Epidemiology and Biostatistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Shilan Wu
- Department of Epidemiology and Biostatistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Chuhao Guo
- Department of Epidemiology and Biostatistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Sisi Long
- Department of Epidemiology and Biostatistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Hongzhuan Tan
- Department of Epidemiology and Biostatistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
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