Probiotic supplementation contributes to glycemic control in adults with type 2 diabetes: A systematic review and network meta-analysis

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Nutrition Research Pub Date : 2025-04-01 DOI:10.1016/j.nutres.2025.03.002

Dengrong Ma , Pingping Zhao , Jie Gao , Hui Suo , Xinyuan Guo , Mei Han , Xiaohui Zan , Chongyang Chen , Xiaoyu Lyu , Hui Wang , Jingfang Liu

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Abstract

Type 2 diabetes mellitus (T2DM) is a chronic medical condition prevalent worldwide. Currently, probiotic therapy has demonstrated favorable outcomes in T2DM management, albeit with a lingering controversy. In this network meta-analysis (NMA), we aimed to assess and rank the glycemic control efficacy of various probiotic strains or combinations in T2DM patients. A systematic literature review was conducted across 4 major databases (PubMed, Embase, Web of Science, and Cochrane Library) including data published up to November 8, 2023, to identify randomized controlled trials (RCTs) on probiotic therapy in T2DM patients. The quality of the included RCTs was evaluated using the risk-of-bias tool version 2, while Bayesian NMA was used for analysis. The efficacy of different probiotics and their combinations was ranked based on the surface under the cumulative ranking curve (SUCRA) for various outcome indicators. This study included 1861 T2DM patients from 30 RCTs. The combination of LAC (Lactobacillus) + BIF (Bifidobacterium) + PRO (Propionibacterium) + STR (Streptococcus) exhibited the most favorable effect in reducing the fasting plasma glucose concentration and improving the homeostatic model assessment of insulin resistance (SUCRA: 88.8% and 77.3%). For reducing the concentration of glycated hemoglobin A1c, BIF (SUCRA: 93.1%) was the most effective; for improving insulin secretion, LAC + BIF (SUCRA: 84.7%) exhibited the most favorable outcome for improving insulin secretion. Cluster analysis of the 4 outcome indicators showed that the LAC + BIF + STR combination may have superior therapeutic effects. Multistrain probiotic combinations demonstrated greater glycemic control effects than single-strain probiotics. Thus, LAC + BIF + STR may be a promising probiotic combination for the treatment of T2DM. Nevertheless, owing to the inherent limitations of existing studies, further research is warranted to ascertain the long-term efficacy of probiotics.

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补充益生菌有助于控制成人2型糖尿病患者的血糖：一项系统综述和网络荟萃分析

2型糖尿病（T2DM）是一种世界范围内普遍存在的慢性疾病。目前，益生菌治疗在T2DM治疗中已显示出良好的效果，尽管仍存在争议。在这项网络荟萃分析（NMA）中，我们旨在评估和排名不同益生菌菌株或组合对T2DM患者的血糖控制效果。我们对4个主要数据库（PubMed、Embase、Web of Science和Cochrane Library）进行了系统的文献综述，包括截至2023年11月8日发表的数据，以确定益生菌治疗2型糖尿病患者的随机对照试验（rct）。采用风险偏倚工具第2版评估纳入的随机对照试验的质量，并使用贝叶斯NMA进行分析。根据各结局指标的累积排序曲线（SUCRA）下曲面对不同益生菌及其组合的功效进行排序。本研究包括来自30项随机对照试验的1861例2型糖尿病患者。LAC (Lactobacillus) + BIF (Bifidobacterium) + PRO (Propionibacterium) + STR （Streptococcus）组合在降低空腹血糖浓度和改善胰岛素抵抗稳态模型评估方面表现出最有利的效果（supra: 88.8%和77.3%）。对于降低糖化血红蛋白A1c浓度，BIF （SUCRA: 93.1%）最有效；在改善胰岛素分泌方面，LAC + BIF （SUCRA: 84.7%）表现出最有利的改善胰岛素分泌的结果。4个结局指标聚类分析显示，LAC + BIF + STR联合治疗可能具有更优的治疗效果。多菌种益生菌组合显示出比单菌种益生菌更大的血糖控制效果。因此，LAC + BIF + STR可能是一种很有前景的治疗2型糖尿病的益生菌组合。然而，由于现有研究的固有局限性，需要进一步的研究来确定益生菌的长期功效。

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来源期刊

Nutrition Research 医学-营养学

CiteScore

7.60

自引率

2.20%

发文量

107

审稿时长

58 days

期刊介绍： Nutrition Research publishes original research articles, communications, and reviews on basic and applied nutrition. The mission of Nutrition Research is to serve as the journal for global communication of nutrition and life sciences research on diet and health. The field of nutrition sciences includes, but is not limited to, the study of nutrients during growth, reproduction, aging, health, and disease. Articles covering basic and applied research on all aspects of nutrition sciences are encouraged, including: nutritional biochemistry and metabolism; metabolomics, nutrient gene interactions; nutrient requirements for health; nutrition and disease; digestion and absorption; nutritional anthropology; epidemiology; the influence of socioeconomic and cultural factors on nutrition of the individual and the community; the impact of nutrient intake on disease response and behavior; the consequences of nutritional deficiency on growth and development, endocrine and nervous systems, and immunity; nutrition and gut microbiota; food intolerance and allergy; nutrient drug interactions; nutrition and aging; nutrition and cancer; obesity; diabetes; and intervention programs.