新型复方益生菌对2型糖尿病患者代谢标志物的影响

Effect of a novel compound probiotic on metabolic markers of type 2 diabetes mellitus

目的探讨一种新型复方益生菌对成人糖尿病前期患者和新近诊断2型糖尿病(T2DM)患者代谢标志物的影响。方法选取60名2019年10月至2020年10月于我院进行治疗(单独饮食或饮食加二甲双胍)的BMI≥25 kg/m^(2)且患有糖尿病前期或新近诊断为T2DM的成人患者为研究对象,按照随机分组原则,将各受试者随机分配到益生菌组(植物乳植杆菌Lp-115、德氏乳杆菌保加利亚亚种Lb-64、加氏乳杆菌Lg-36、短双歧杆菌Bb-03、动物双歧杆菌动物亚种、乳杆菌Bi-07、两歧双歧杆菌Bb-06、唾液链球菌嗜热亚种St-21和布拉酵母菌DBVPG.6763)和安慰剂组,每组各30名,干预治疗12周后,比较两组患者糖尿病代谢标志物水平变化。结果益生菌组和安慰剂组患者的主要和次要指标水平差异均无统计学意义(均P<0.05)。服用二甲双胍者空腹血糖、糖化血红蛋白、胰岛素抵抗、Zonulin蛋白和血浆丁酸盐水平增加。益生菌组患者肠道微生物产丁酸盐的作用升高,但安慰剂组患者未见此现象。结论益生菌可以通过增加丁酸盐的产生而作为二甲双胍的辅助剂,增强患者葡萄糖的代谢。

Objective To observe the effect of a new type of compound probiotics on the metabolic markers of adult prediabetes and newly diagnosed type 2 diabetes(T2DM).Methods Sixty adults who were treated in our hospital from October 2019 to October 2020(diet alone or diet plus metformin)with BMI≥25 kg/m^(2)and pre-diabetes or newly diagnosed T2DM were selected according to the principle of randomization;each subject was randomly assigned to probiotics group(Lactiplantibacillus plantarum Lp-115,Lactobacillus elbrueckii subsp.bulgaricus Lb-64,Lactobacillus gasseri Lg-36,Bifidobacterium breve Bb-03,Bifidobacterium animalis subsp.animalis,Lactobacillus Bi-07,Bifidobacterium bifidum Bb06,Streptococcus salivarius subsp.thermophilus St-21 and Saccharomyces boulardii DBVPG 6763)or placebo group,30 in each group.After 12 weeks of intervention treatment,the changes of diabetes metabolic markers were compared between the two groups.Results There were no significant differences in the primary and secondary outcome indicators between the probiotic group and the placebo group(all P<0.05).Subgroup analysis of participants taking metformin showed that fasting blood glucose,glycosylated hemoglobin,insulin resistance,Zonulin protein and plasma butyrate concentrations increased;microbial butyrate production function was enriched in the probiotic group,but not in the placebo group.Conclusion Probiotics can act as an adjuvant to metformin by increasing the production of butyrate,thereby enhancing glucose management.