Effect of metformin on gut microbiota imbalance in patients with T2DM, and the value of probiotic supplementation.

IF 2.5 4区医学 Q3 ALLERGY

Allergologia et immunopathologia Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI:10.15586/aei.v52i4.1101

Lu Li, Yanli Chen, Zhipeng Tang, Yan You, Yang Guo, Yong Liao

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Abstract

Purpose: To investigate the effect of metformin on gut microbiota imbalance in patients with type 2 diabetes mellitus (T2DM), and the value of probiotic supplementation.

Methods: A total of 84 newly diagnosed T2DM patients were randomly divided into probiotics group, metformin group, and control group, with 28 patients in each group. The blood glucose control, islet function, gut microbiota, and inflammatory factors were compared between three groups.

Results: After 3 months of treatment, fasting plasma glucose (FPG), 2-h postprandial plasma glucose (2-h PG), and glycosylated hemoglobin A1c (HbA1c) were evidently decreased in both probiotics and metformin groups (P < 0.05) and were lower than that in the control group prior to treatment. Besides, FPG, 2-h PG, and HbA1c were lower in the metformin group than that in the control group. FPG, 2-h PG, and HbA1c were further lower in the probiotic group than in the metformin group (P < 0.05). Fasting insulin (FINS) and islet β cell (HOMA-β) -function were dramatically increased in the same group (P < 0.05), while insulin-resistant islet β cells (HOMA-IR) were significantly lower in the same group (P < 0.05); FINS and HOMA-β were significantly higher, while HOMA-IR was significantly lower (P < 0.05) in both groups than in the control group prior to treatment. HOMA-IR was also lower in the probiotic group than in the metformin group after treatment (P < 0.05); the number of lactobacilli and bifidobacteria increased (P < 0.05) in both probiotic and metformin groups than in the control group prior to treatment, and the number of Enterobacteriaceae and Enterococcus was lower in the control group prior to treatment (P < 0.05). In addition, the number of lactobacilli and bifidobacteria was higher and the number of enterobacteria and enterococci was lower in the probiotic group than that in the metformin group after treatment, and the differences were statistically significant (P < 0.05). Lipopolysaccharide (LPS), interleukin 6 (IL-6), and C-reactive protein (CRP) levels were lower in both probiotic and metformin groups (P < 0.05). The serum LPS, IL-6, and CRP levels were lower in both probiotic and metformin groups, compared to the control group prior to the treatment (P < 0.05).

Conclusion: Metformin while treating T2DM assists in improving the imbalance of gut microbiota.

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二甲双胍对 T2DM 患者肠道微生物群失衡的影响，以及补充益生菌的价值。

目的：研究二甲双胍对2型糖尿病（T2DM）患者肠道微生物群失衡的影响，以及补充益生菌的价值：方法：将84名新确诊的T2DM患者随机分为益生菌组、二甲双胍组和对照组，每组28人。比较三组患者的血糖控制、胰岛功能、肠道微生物群和炎症因子：治疗 3 个月后，益生菌组和二甲双胍组的空腹血浆葡萄糖（FPG）、餐后 2 小时血浆葡萄糖（2-h PG）和糖化血红蛋白 A1c（HbA1c）均明显下降（P < 0.05），且低于治疗前的对照组。此外，二甲双胍组的 FPG、2-h PG 和 HbA1c 也低于对照组。益生菌组的 FPG、2-h PG 和 HbA1c 比二甲双胍组进一步降低（P < 0.05）。同组的空腹胰岛素（FINS）和胰岛β细胞（HOMA-β）功能显著增加（P＜0.05），而同组的胰岛β细胞胰岛素抵抗（HOMA-IR）显著降低（P＜0.05）；与治疗前的对照组相比，两组的FINS和HOMA-β显著增加，而HOMA-IR显著降低（P＜0.05）。治疗后，益生菌组的HOMA-IR也低于二甲双胍组（P＜0.05）；益生菌组和二甲双胍组的乳酸杆菌和双歧杆菌数量均比治疗前的对照组增加（P＜0.05），而肠杆菌属和肠球菌数量则低于治疗前的对照组（P＜0.05）。此外，治疗后益生菌组的乳酸杆菌和双歧杆菌数量高于二甲双胍组，肠杆菌和肠球菌数量低于二甲双胍组，差异有统计学意义（P < 0.05）。益生菌组和二甲双胍组的脂多糖（LPS）、白细胞介素6（IL-6）和C反应蛋白（CRP）水平均较低（P < 0.05）。与治疗前的对照组相比，益生菌组和二甲双胍组的血清 LPS、IL-6 和 CRP 水平均较低（P < 0.05）：结论：二甲双胍在治疗 T2DM 的同时有助于改善肠道微生物群的失衡。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Allergologia et immunopathologia 医学-过敏

CiteScore

3.70

自引率

0.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： Founded in 1972 by Professor A. Oehling, Allergologia et Immunopathologia is a forum for those working in the field of pediatric asthma, allergy and immunology. Manuscripts related to clinical, epidemiological and experimental allergy and immunopathology related to childhood will be considered for publication. Allergologia et Immunopathologia is the official journal of the Spanish Society of Pediatric Allergy and Clinical Immunology (SEICAP) and also of the Latin American Society of Immunodeficiencies (LASID). It has and independent international Editorial Committee which submits received papers for peer-reviewing by international experts. The journal accepts original and review articles from all over the world, together with consensus statements from the aforementioned societies. Occasionally, the opinion of an expert on a burning topic is published in the "Point of View" section. Letters to the Editor on previously published papers are welcomed. Allergologia et Immunopathologia publishes 6 issues per year and is included in the major databases such as Pubmed, Scopus, Web of Knowledge, etc.