Probiotics and synbiotics show clinical efficacy in treating gestational diabetes mellitus: A meta-analysis

Published:August 17, 2021DOI:https://doi.org/10.1016/j.pcd.2021.08.005

      Highlights

      • The consumption of probiotic/synbiotic supplements is a strategy for the management of glucose and lipid concentrations.
      • The consumption of probiotic/synbiotic supplements has anti-inflammation and antioxidant benefits in GDM patients.
      • The microbiome is critical in the metabolism of GDM patients.

      Abstract

      Background

      This study performed a systematic and meta-analysis of randomized controlled trials (RCTs) to explore the efficacy of probiotic- and symbiotic-based supplements in the treatment of gestational diabetes mellitus (GDM).

      Methods

      We performed a meta-analysis to evaluate the efficacy of probiotics/synbiotics in GDM treatment, following a systematic search in Web of Science, PubMed, Cochrane Library, and EBSCO databases for articles published up to July 2020.

      Results

      In total, 12 RCTs comprising 894 participants, were analyzed. Compared to the placebo, patients administered with probiotic and synbiotic supplements benefited more with regards to glucose and lipid metabolism as well as anti-inflammation and antioxidant capacity including insulin of change (WMD: 3.57, 95%CI: −5.26, −1.88), very-low-density lipoprotein (VLDL) (WMD: −5.03, 95%CI: −8.26, −1.79), nitric oxide (NO) at the end of trial (WMD: 2.31, 95%CI: 0.91, 3.70), total antioxidant capacity (TAC) at the end of trial (SMD: 0.74, 95%CI: 0.21, 1.27), high-sensitivity C-reactive protein (hsCRP) at the end of trial (SMD: −1.23, 95%CI: −1.97, −0.49). Besides, probiotic and synbiotic supplements improved outcomes on fetal hyperbilirubinemia risk (RR: 0.26, 95%CI: 0.12, 0.55), fetal macrosomia risk (RR: 0.47, 95%CI: 0.27, 0.83) and newborn weight (SMD: −0.29, 95%CI: −0.50, −0.09).

      Conclusions

      Findings from this work demonstrate that probiotic/symbiotic-based interventions improve glucose and lipid metabolism, anti-inflammatory and antioxidant ability in diet-controlled GDM patients, and exert beneficial outcomes on fetal hyperbilirubinemia, fetal macrosomia, and newborn weight.

      Graphical abstract

      Abbreviations:

      GDM (Gestational diabetes mellitus), RCTs (Randomized controlled trials), BMI (Body mass index), FPG (Fasting plasma glucose), OGTT (Oral glucose tolerance test), HOMA-IR (Homeostatic model assessment for insulin resistance), HOMA-B (Homeostatic model assessment for B-cell function), HDL (High-density lipoprotein), LDL (Low-density lipoprotein), VLDL (Very-low-density lipoprotein), NO (Nitric oxide), TAC (Total antioxidant capacity), hsCRP (High-sensitivity C-reactive protein), GSH (Glutathione), MDA (Malondialdehyde), NICU (Neonatal intensive care unit), WMD (Weighted mean difference), SMD (Standardized mean difference), CI (Confidence intervals), RR (Risk ratio), T2DM (Type 2 diabetes mellitus), SCFAs (Short-chain fatty acids), GLP-1 (Glucagon-like peptide-1), FA (Fatty acid), ROS (Reactive oxygen species)

      Keywords

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