Effect of Probiotics on Glucose and Lipid Metabolism in Type 2 Diabetes Mellitus: A Meta-Analysis of 12 Randomized Controlled Trials
Kecheng Yao, Linghai Zeng, Qian He, Wei Wang, Jiao Lei, Xiulan Zou
(Department of Gerontology, Renmin Hospital of Three Gorges University and The First People’s Hospital of Yichang, Yichang, Hubei, China (mainland))
Med Sci Monit 2017; 23:3044-3053
It has been unclear whether supplemental probiotics therapy improves clinical outcomes in type 2 diabetic patients. This meta-analysis aimed to summarize the effect of probiotics on glucose and lipid metabolism and C-reactive protein (CRP) from 12 randomized controlled trials (RCTs).
MATERIAL AND METHODS: An up-to-date search was performed for all relevant RCTs up to April 2016 from PubMed, Embase, and Cochrane Library. Standardized mean difference (SMD) and weighted mean difference (WMD) were calculated for a fixed-effect and random-effect meta-analysis to assess the impact of supplemental probiotics on fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), lipid profile, and CRP level.
RESULTS: A total of 12 studies (684 patients) were entered into the final analysis. The effect of probiotics was significant on reducing HbA1c level (standardized mean difference [SMD], –0.38; confidence interval [CI], –0.62 to –0.14, P=0.002; I²=0%, P=0.72 for heterogeneity), fasting insulin level (SMD, –0.38; CI –0.59 to –0.18, P=0.0003; I²=0%, P=0.81 for heterogeneity), and HOMA-IR (SMD, –0.99; CI –1.52 to –0.47, P=0.0002; I²=86%, P<0.00001 for heterogeneity). Pooled results on effects of probiotics on FPG, CRP, or lipid profile were either non-significant or highly heterogeneous.
CONCLUSIONS: This meta-analysis demonstrated that probiotics supplementation was associated with significant improvement in HbA1c and fasting insulin in type 2 diabetes patients. More randomized placebo-controlled trials with large sample sizes are warranted to confirm our conclusions.
Keywords: Diabetes Mellitus, Type 2, meta-analysis, Probiotics