The effect of probiotic and synbiotic supplementation on lipid parameters among patients with cardiometabolic risk factors: a systematic review and meta-analysis of clinical trials

Abstract

Although the available evidence emphasizes the beneficial effects of probiotics in normalizing various cardiometabolic markers, there is still substantial uncertainty in this regard. Thus, we set out to determine the effect sizes of probiotics on blood lipid parameters more coherently. A systematic literature search of the Medline (PubMed) and Scopus databases was conducted from inception to February 12, 2021, applying both MeSH terms and free text terms to find the relevant randomized controlled trials (RCTs). The meta-analysis was conducted based on a random-effect model to calculate the mean effect sizes demonstrated as weighted mean differences (WMD) and the 95% confidence intervals (95%CI). To explore the heterogeneity, the Cochrane Chi-squared test, and analysis of Galbraith plots were performed. Meta-analysis of data from 40 RCTs (n = 2795) indicated a significant decrease in serum/plasma triglyceride (WMD (95%CI) -12.26 (-17.11- -7.41) mg/dL; P-value <0.001; I2 (%)= 29.9; P heterogeneity = 0.034)), total cholesterol (with high heterogeneity) (WMD (95%CI) -8.43 (-11.90- -4.95) mg/dL; P-value <0.001; I2 (%) =56.8; P heterogeneity < 0.001), LDL-C (WMD (95%CI) -5.08 (-7.61, -2.56) mg/dL; P-value <0.001; I2 (%) =42.7; P heterogeneity =0.002), and HDL-C (with high heterogeneity) (WMD (95%CI) 1.14 (0.23, 2.05) mg/dL; P-value =0.014; I2 (%) = 59.8; P heterogeneity < 0.001) following receiving probiotic/synbiotic supplements. Collectively, the current preliminary evidence supports the effectiveness of probiotics/synbiotics in improving dyslipidemia and various lipid parameters more prominently among subjects with hyperlipidemia, diabetes, and metabolic syndrome. However, large and well conducted RCTs are required to provide further convincing support for these results.

Controlled and Synchronised Vascular Regeneration upon the Implantation of Iloprost- and Cationic Amphiphilic Drugs-Conjugated Tissue-Engineered Vascular Grafts into the Ovine Carotid Artery: A Proteomics-Empowered Study

“…First, a specific diet including recently defined factors of cardiovascular resilience such as calorie restriction, intermittent fasting, meal timing (i.e., adjusted diurnal rhythm of feeding), antioxidant-rich diet, and increased physical activity [ 81 , 82 ] might reduce the cardiovascular risk factor burden, retard the developing vascular occlusion, and improve the implantation outcomes. Intake of pre-, pro-, or synbiotics to manage a physiological gut microbiota profile might have synergistic effects with a healthy dietary pattern in the cardiovascular context [ 83 , 84 , 85 , 86 , 87 ]. Yet, the impact of pharmacological or nutritional interventions on the outcomes of TEVG implantation has not been evaluated to-date.…”

Nutritional supplements improve cardiovascular risk factors in overweight and obese patients: A Bayesian network meta-analysis

“…Therefore, they have attracted extensive attention in the treatment of metabolic diseases. According to previous meta-analysis, resveratrol, Vitamin D (VD)/VD + calcium (Ca), probiotics, α-lipoic acid, omega-3, curcumin, and magnesium (Mg) were used to improve multiple comorbidities of metabolic disorders (11)(12)(13)(14)(15)(16)(17). While most RCTs and meta-analysis to date have proved the beneficial effect of nutritional supplements on metabolism diseases patients, limited data are available regarding their effects on other indicators of CVD risk, i.e., metabolic syndrome (MetS) (18), elevated blood pressure (19), endothelial function (20), and in other at-risk populations.…”

“…Our NMA also provides compelling evidence for the benefits of probiotics in improving blood glucose metabolism. Different studies have explained the potential hypoglycemic mechanisms of probiotics, and most studies believe that it may be related to gut bacteria, increasing satiety and reducing appetite (13,(100)(101)(102). A variety of probiotics, such as Bifidobacterium and Lactobacillus, were used in the included studies.…”

Comparative analysis of the prebiotic effect of Fructooligosaccharides and Raffinose oligosaccharides on nutraceutical and sensory properties of soymilk fermented with mixed cultures of Lacticaseibacillus rhamnosus and Weissella confusa 30082b

“…The International Scientific Association for Probiotics and Prebiotics (ISAPP) recently updated the definition of a synbiotic to "a mixture comprising live microorganisms and substrate(s) selectively utilised by host microorganisms that confer a health benefit on the host" (Swanson et al 2020). Intake of synbiotics has been identified to enhance the immune response, haemato-immunological serum parameters, and intestinal fermentation in the host (Ghorbani et al 2023). To be a synergistic synbiotic, the probiotic microorganism chosen must be entrenched in its ability to deliver a health benefit, and the prebiotic substrate is selected to essentially aid the growth and activity of that particular prebiotic microorganism.…”