The effect of probiotic and synbiotic supplementation on appetite-regulating hormones and desire to eat: A systematic review and meta-analysis of clinical trials.

Recent studies have demonstrated the effect of probiotics, prebiotics, and synbiotics on adiponectin and leptin levels; however, those findings remain contested. The present study aimed to explore the impact of probiotics/synbiotics on appetite-regulating hormones and the desire to eat. A systematic review was conducted by searching the Medline (PubMed) and Scopus databases from inception to December 2021, using relevant keywords and MeSH terms, and appropriate randomized controlled trials (RCTs) were extracted. The standardized mean differences (SMD) and 95% confidence intervals (95%CIs) were calculated as part of the meta-analysis using a random-effect model to determine the mean effect sizes. Analysis of Galbraith plots and the Cochrane Chi-squared test were conducted to examine heterogeneity. Meta-analysis of data from a total of 26 RCTs (n = 1536) showed a significant decrease in serum/plasma leptin concentration following probiotic/synbiotic supplementation (SMD: -0.38, 95%CI= -0.638, -0.124); P-value= 0.004; I2= 69.4%; P heterogeneity < 0.001). The leptin level decrease from probiotic/synbiotic supplementation was higher in patients with NAFLD than those with overweight/obesity or type 2 diabetes mellitus/ metabolic syndrome/ prediabetes. Probiotic/synbiotic supplementation was associated with a trending increase in adiponectin levels, stronger in patients with type 2 diabetes mellitus, metabolic syndrome, and prediabetes (SMD: 0.25, 95%CI= 0.04, 0.46) µg/mL; P-value= 0.021; I2 = 16.8%; P heterogeneity= 0.30). Additionally, supplementation with probiotic/synbiotic was linked to a slight increase in desire to eat (SMD: 0.34, 95%CI= 0.03, 0.66) P-value = 0.030; I2 = 39.4%; P heterogeneity= 0.16). Our meta-analysis indicates a favorable impact of probiotic/synbiotic supplementation on regulating leptin and adiponectin secretion.

Noormohammadi M ，Ghorbani Z ，Löber U ，Mahdavi-Roshan M ，Bartolomaeus TUP ，Kazemi A ，Shoaibinobarian N ，Forslund SK ... -  《-》

The effects of probiotic and synbiotic supplementation on inflammation, oxidative stress, and circulating adiponectin and leptin concentration in subjects with prediabetes and type 2 diabetes mellitus: a GRADE-assessed systematic review, meta-analysis, an

Probiotics or synbiotics consumption have been suggested to reduce the risk of cardiovascular disease (CVD) through a decline in inflammation and oxidative stress, however, the results from studies are conflicting. This study filled this knowledge gap by evaluating randomized controlled trials (RCTs) investigating probiotics or synbiotics intake on adipokines, inflammation, and oxidative stress in patients with prediabetes and type-2 diabetes mellitus (T2DM). We systematically did search up to March 2022 in PubMed/Medline, Scopus, ISI Web of Science, and Cochrane library. A random-effect model was applied to estimate the weighted mean difference (WMD) and 95% confidence interval (95% CI) for each outcome. A total of 32 RCTs were included in the meta-analysis. This intervention led to a significant decrease in levels of C-reactive protein (CRP) (WMD - 0.62 mg/l; 95% CI - 0.80, - 0.44; p < 0.001), tumor necrosis factor-α (TNF-α) (WMD - 0.27 pg/ml; 95% CI - 0.44, - 0.10; p = 0.002) and malondialdehyde (MDA) (WMD - 0.51 µmol/l; 95% CI - 0.73, - 0.30; p < 0.001), and also a significant increase in levels of glutathione (GSH) (WMD 69.80 µmol/l; 95% CI 33.65, 105.95; p < 0.001), total antioxidant capacity (TAC) (WMD 73.59 mmol/l; 95% CI 33.24, 113.95; p < 0.001) and nitric oxide (NO) (WMD 7.49 µmol/l; 95% CI 3.12, 11.86; p = 0.001), without significant alterations in interleukin-6 (IL-6) and adipokines levels. A consumption of probiotics or synbiotics could be a useful intervention to improve cardiometabolic outcomes through a reduced inflammation and oxidative stress in patients with prediabetes and T2DM.

Naseri K ，Saadati S ，Ghaemi F ，Ashtary-Larky D ，Asbaghi O ，Sadeghi A ，Afrisham R ，de Courten B ... -  《-》

Effects of probiotic/prebiotic/synbiotic supplementation on blood glucose profiles: a systematic review and meta-analysis of randomized controlled trials.

Previous studies have evaluated the effects of probiotic/prebiotic/synbiotic supplementation on blood glucose profiles among diabetic patients. However, the results were inconsistent. Systematic review and meta-analysis. A systematic searching from PubMed, ISI Web of Science, Embase, and Cochrane Central was conducted to identify high-quality clinical trials investigating the effect of probiotic/prebiotic/synbiotic supplementation on blood glucose profiles [including fasting blood glucose (FBG), hemoglobin A1c (HbA1c), and homeostasis model assessment of insulin resistance (HOMA-IR)] up to December 2020. Subgroup analyses by types or durations of probiotic/prebiotic/synbiotic supplementation were conducted to investigate the different effects among different populations. A total of 39 trials with 3517 participants were included in the final analyses. Among patients with type II diabetes (T2DM), the summarized standardized mean differences (SMDs) and 95% confidential intervals (95% CIs) of FBG, HbA1c, and HOMA-IR were -0.30 (95% CI: -0.65 to 0.05), -0.59 (95% CI: -0.88 to -0.30), and -0.68 (95% CI: -1.13 to -0.23), respectively. Among patients with gestational diabetes (GDM), the summary SMDs of FBG, HbA1c and HOMA-IR were -0.67 (95% CI: -1.23 to -0.11), -0.24 (95% CI: -0.57 to 0.08), and -1.06 (95% CI: -1.72 to -0.40), respectively. Similar improvements in blood glucose profiles were also found among persons with prediabetes or gestational woman with normal glucose, but not among patients with type I diabetes. Subgroup analyses showed similar results of probiotic supplementation for patients with T2DM and probiotic/synbiotic supplementation for patients with GDM. Probiotic/prebiotic/synbiotic supplementation might improve the blood glucose profiles among patients with T2DM/GDM, persons with prediabetes, or gestational woman with normal glucose. Trials with more sophisticated design are needed to validate the results in the future. PROSPERO CRD42020161975.

Wang Z ，Li W ，Lyu Z ，Yang L ，Wang S ，Wang P ，Song F ，Chen K ，Huang Y ... -  《-》

The effect of probiotic and synbiotic supplementation on biomarkers of inflammation and oxidative stress in diabetic patients: A systematic review and meta-analysis of randomized controlled trials.

The role of gut microbiota in the management of diabetes has been shown. Several current trials are investigating the effect of probiotics and prebiotics, which are widely used to modulate intestinal microbiota, on inflammatory factors and biomarkers of oxidative stress in diabetic patients; however, their findings are controversial. The aim of the current meta-analysis was to evaluate the effects of probiotic and synbiotic supplementation on levels of serum high-sensitivity C-reactive protein (hs-CRP) and biomarkers of oxidative stress in diabetic patients. We searched the PubMed, Web of Science, and The Cochrane Library databases from the inception to October 31, 2018. Randomized controlled trials (RCTs) which reported the effect of probiotics or synbiotics on circulating (serum and plasma) inflammatory marker (hs-CRP) and oxidative stress indicators (malondialdehyde [MDA], glutathione [GSH], nitric oxide [NO], and total antioxidant capacity [TAC]) among patients with diabetes were included. Eligible studies were assessed for risk of bias and subjected to qualitative and quantitative synthesis using either fixed- or random-effects models accounting for clinical heterogeneity. Our meta-analysis identified 16 eligible RCTs (n = 1060). The methodological quality varied across these trials. Pooled data from these trials demonstrated that probiotic and synbiotic consumption significantly decreased hs-CRP level (standardized mean difference [SMD]=-0.38; 95% confidence interval [CI]:-0.51,-0.24; P = 0.000) and MDA (SMD=-0.61; 95% CI: -0.89, -0.32; P = 0.000) in diabetic patients compared to those in subjects receiving placebos. In addition, probiotic and symbiotic supplementation was found to increase TAC (SMD = 0.31; 95% CI: 0.09, 0.52; P = 0.006), NO (SMD, 0.62; 95% CI, 0.25 to 0.99; P = 0.001) and GSH (SMD = 0.41; 95% CI: 0.26, 0.55, P = 0.000) levels. The results of this systematic review and meta-analysis suggest that probiotic and synbiotic supplementation may help to improve biomarkers of inflammation and oxidative stress in diabetic patients. Further studies are needed to develop clinical practice guidelines for the management of inflammation and oxidative stress in these patients.

Zheng HJ ，Guo J ，Jia Q ，Huang YS ，Huang WJ ，Zhang W ，Zhang F ，Liu WJ ，Wang Y ... -  《-》

Do probiotics, prebiotics and synbiotics affect adiponectin and leptin in adults? A systematic review and meta-analysis of clinical trials.

Human studies have reported controversial findings regarding the health promoting effects of probiotic, prebiotic and synbiotic on adiponectin and leptin levels. This systematic review and meta-analysis was conducted to understand the effect of probiotics, prebiotics or synbiotics on adiponectin and leptin levels in adults. Electronic searches were performed in PubMed, Scopus, Web of Science, Cochrane Library and Google scholar up to February 11, 2018 without any restriction. Controlled clinical trials, in any age of adults, which reported the effect of probiotic, prebiotic and synbiotic on serum level of adiponectin and leptin were included. As leptin and adiponectin were reported in different units across the studies, Hedges's adjusted g was used to calculate effect size. A random-effects model was used to pool calculated effect sizes. Of 12 eligible studies, 10 publications focused on probiotics, and only 3 studies reported the effect of prebiotics (n = 2) or synbiotics (n = 1) on leptin and adiponectin. There were no significant changes in adiponectin (Hedges' g = -0.04; 95% CI: -0.27, 0.19) and leptin (Hedges' g = -0.30; 95% CI: -0.86, 0.26) in probiotic group compared with controls. Subgroup analyses ranged in heterogeneity from 0% to 93%, but no subgroup showed an effect of probiotics on adiponectin or leptin. There were limited studies regarding the effect of prebiotic and synbiotic on adiponectin and leptin. Although previous studies reported several health promoting effects of probiotics, we could not find any pooled effect on adiponectin and leptin.

Rouhani MH ，Hadi A ，Ghaedi E ，Salehi M ，Mahdavi A ，Mohammadi H ... -  《-》