The Effects of Probiotic Supplementation on Genetic and Metabolic Profiles in Patients with Gestational Diabetes Mellitus: a Randomized, Double-Blind, Placebo-Controlled Trial

• Published in: Probiotics and antimicrobial proteins Vol. 11; no. 4; pp. 1227 - 1235
• Main Authors: Babadi, Mahtab, Khorshidi, Ahmad, Aghadavood, Esmat, Samimi, Mansooreh, Kavossian, Elham, Bahmani, Fereshteh, Mafi, Alireza, Shafabakhsh, Rana, Satari, Mahbobeh, Asemi, Zatollah
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-12-2019; Springer Nature B.V
• Subjects: Antioxidants; Applied Microbiology; Chemistry; Chemistry and Materials Science; Chemistry/Food Science; Cholesterol; Clinical trials; Diabetes; Diabetes mellitus; Dietary supplements; Double-blind studies; Gene expression; Growth factors; High density lipoprotein; Hypoglycemic agents; Inflammation; Insulin; Insulin resistance; Leukocytes (mononuclear); Lipoproteins (very low density); Malondialdehyde; Metabolism; Microbiology; Nitric oxide; Nutrition; Oxidative stress; Peripheral blood mononuclear cells; Probiotics; Protein Science; Transforming growth factor-b; Triglycerides; Tumor necrosis factor-α; Vascular endothelial growth factor; Yogurt; Gestational diabetes mellitus; Metabolic status; Insulin resistance; Inflammation; Probiotic supplementation
• ISSN: 1867-1306; 1867-1314
• DOI: 10.1007/s12602-018-9490-z

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 × 10
9
 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.