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Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Meta-Analysis

Can Probiotics Supplementation Improve Glycemic and Renal Status in Diabetic Nephropathy? A Systematic Review and Meta-Analysis of Clinical Trials

Author(s): Mohammad Javad Tarrahi , Iman Namjoo, Mohammad Borzoo-Isfahani, Hadiseh Ebdali and Amir Reza Moravejolahkami*

Volume 22, Issue 1, 2022

Published on: 21 January, 2021

Page: [143 - 158] Pages: 16

DOI: 10.2174/1871530321666210121154037

Price: $65

Abstract

Background & Aim: This meta-analysis was performed to quantify the effects of probiotics on renal and glycemic biomarkers among patients with Diabetic Nephropathy (DN).

Methods: Electronic databases were searched on May 10, 2020. All trials that investigated the effect of probiotics on serum glycemic markers (Fasting Plasma Glucose [FPG], Hemoglobin A1C, Insulin, Homeostatic Model Assessment-Insulin Resistance [HOMA-IR], and Quantitative Insulin Sensitivity Check Index [QUICKI]), and renal status markers (Creatinine [Cr], Blood Urea Nitrogen [BUN], and Glomerular Filtration Rate [GFR]) were included.

Results: Seven trials that included 340 patients were identified for analysis. The results indicated that probiotics significantly reduced FPG (WMD= -19.08 mg/dl; 95% CI= -32.16, -5.99; P=0.004), HOMA-IR (WMD= -1.88; 95% CI= -3.63, -0.12; P=0.036), and Cr (WMD= -0.18 mg/dl; 95% CI= -0.26, -0.09; P<0.001) levels in DN patients; however, there was no statistically significant change in Hemoglobin A1C, Insulin, QUICKI, BUN, and GFR.

Conclusion: This meta-analysis supports the potential use of probiotics in the improvement of some glycemic and renal biomarkers in patients with DN.

Keywords: Probiotics, clinical laboratory techniques, diabetic nephropathies, meta-analysis, systematic review, clinical trials.

Graphical Abstract
[1]
Pezzolesi, M.G.; Krolewski, A.S. The Genetics of Diabetic Nephropathy.Diabetic Nephropathy; Springer. , 2019, pp. 89-112.
[http://dx.doi.org/10.1007/978-3-319-93521-8_7]
[2]
Sagoo, M.K.; Gnudi, L. Diabetic Nephropathy: An Overview.Diabetic Nephropathy; Springer. , 2020, pp. 3-7.
[http://dx.doi.org/10.1007/978-1-4939-9841-8_1]
[3]
Al-Hasani, K.; Khurana, I.; Farhat, T.; Eid, A.; El-Osta, A. Epigenetics of diabetic nephropathy: from biology to therapeutics. EMJ, 2020, 5(1), 48-57.
[4]
Jones, C.A.; Krolewski, A.S.; Rogus, J.; Xue, J.L.; Collins, A.; Warram, J.H. Epidemic of end-stage renal disease in people with diabetes in the United States population: do we know the cause? Kidney Int., 2005, 67(5), 1684-1691.
[http://dx.doi.org/10.1111/j.1523-1755.2005.00265.x] [PMID: 15840014]
[5]
Hoshino, J.; Mise, K.; Ueno, T.; Imafuku, A.; Kawada, M.; Sumida, K.; Hiramatsu, R.; Hasegawa, E.; Yamanouchi, M.; Hayami, N.; Suwabe, T.; Sawa, N.; Hara, S.; Fujii, T.; Ohashi, K.; Ubara, Y.; Takaichi, K. A pathological scoring system to predict renal outcome in diabetic nephropathy. Am. J. Nephrol., 2015, 41(4-5), 337-344.
[http://dx.doi.org/10.1159/000431333] [PMID: 26067713]
[6]
Sircana, A.; De Michieli, F.; Parente, R.; Framarin, L.; Leone, N.; Berrutti, M.; Paschetta, E.; Bongiovanni, D.; Musso, G. Gut microbiota, hypertension and chronic kidney disease: Recent advances. Pharmacol. Res., 2019, 144, 390-408.
[http://dx.doi.org/10.1016/j.phrs.2018.01.013] [PMID: 29378252]
[7]
Pascale, A.; Marchesi, N.; Govoni, S.; Coppola, A.; Gazzaruso, C. The role of gut microbiota in obesity, diabetes mellitus, and effect of metformin: new insights into old diseases. Curr. Opin. Pharmacol., 2019, 49, 1-5.
[http://dx.doi.org/10.1016/j.coph.2019.03.011] [PMID: 31015106]
[8]
Hu, Z.B.; Lu, J.; Chen, P.P.; Lu, C.C.; Zhang, J.X.; Li, X.Q.; Yuan, B.Y.; Huang, S.J.; Ruan, X.Z.; Liu, B.C.; Ma, K.L. Dysbiosis of intestinal microbiota mediates tubulointerstitial injury in diabetic nephropathy via the disruption of cholesterol homeostasis. Theranostics, 2020, 10(6), 2803-2816.
[http://dx.doi.org/10.7150/thno.40571] [PMID: 32194836]
[9]
Trimarchi, H.; Coppo, R. Podocytopathy in the mesangial proliferative immunoglobulin A nephropathy: new insights into the mechanisms of damage and progression. Nephrol. Dial. Transplant., 2019, 34(8), 1280-1285.
[http://dx.doi.org/10.1093/ndt/gfy413] [PMID: 30698804]
[10]
He, C.; Shan, Y.; Song, W. Targeting gut microbiota as a possible therapy for diabetes. Nutr. Res., 2015, 35(5), 361-367.
[http://dx.doi.org/10.1016/j.nutres.2015.03.002] [PMID: 25818484]
[11]
Everard, A.; Cani, P.D. Gut microbiota and GLP-1. Rev. Endocr. Metab. Disord., 2014, 15(3), 189-196.
[http://dx.doi.org/10.1007/s11154-014-9288-6] [PMID: 24789701]
[12]
Gibson, G.R.; Hutkins, R.; Sanders, M.E.; Prescott, S.L.; Reimer, R.A.; Salminen, S.J.; Scott, K.; Stanton, C.; Swanson, K.S.; Cani, P.D.; Verbeke, K.; Reid, G. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat. Rev. Gastroenterol. Hepatol., 2017, 14(8), 491-502.
[http://dx.doi.org/10.1038/nrgastro.2017.75] [PMID: 28611480]
[13]
Roobab, U.; Batool, Z.; Manzoor, M.F.; Shabbir, M.A.; Khan, M.R.; Aadil, R.M. sources, formulations, advanced delivery and health benefits of probiotics. Curr. Opin. Food Sci., 2020, 32, 17-28.
[http://dx.doi.org/10.1016/j.cofs.2020.01.003]
[14]
Moravejolahkami, A; Chitsaz, A. Mediterranean-style diet co-supplemented with synbiotics improved quality of life, fatigue and disease activity in five secondary progressive multiple sclerosis patients. Ann. Med. Surg. Case Rep. AMSCR, 2019, 2019(02), 100006.
[15]
Bahreini-Esfahani, N.; Moravejolahkami, A.R. Can synbiotic dietary pattern predict lactobacillales strains in breast milk? Breastfeed. Med., 2020, 15(6), 387-393.
[http://dx.doi.org/10.1089/bfm.2019.0301] [PMID: 32311272]
[16]
Askari, G.; Moravejolahkami, A.R. Synbiotic supplementation may relieve anterior uveitis, an ocular manifestation in Behcet’s syndrome. Am. J. Case Rep., 2019, 20, 548-550.
[http://dx.doi.org/10.12659/AJCR.912023] [PMID: 31000688]
[17]
Lee, T.H.; Park, D.; Kim, Y.J.; Lee, I.; Kim, S.; Oh, C.T.; Kim, J.Y.; Yang, J.; Jo, S.K. Lactobacillus salivarius BP121 prevents cisplatin‑induced acute kidney injury by inhibition of uremic toxins such as indoxyl sulfate and p‑cresol sulfate via alleviating dysbiosis. Int. J. Mol. Med., 2020, 45(4), 1130-1140.
[http://dx.doi.org/10.3892/ijmm.2020.4495] [PMID: 32124946]
[18]
Bhardwaj, R.; Singh, B.P.; Sandhu, N.; Singh, N.; Kaur, R.; Rokana, N.; Singh, K.S.; Chaudhary, V.; Panwar, H. Probiotic mediated NF-κB regulation for prospective management of type 2 diabetes. Mol. Biol. Rep., 2020, 47(3), 2301-2313.
[http://dx.doi.org/10.1007/s11033-020-05254-4] [PMID: 31919753]
[19]
Mihailović, M.; Živković, M.; Jovanović, J.A.; Tolinački, M.; Sinadinović, M.; Rajić, J. Oral administration of probiotic Lactobacillus paraplantarum BGCG11 attenuates diabetes-induced liver and kidney damage in rats. J. Funct. Foods, 2017, 38, 427-437.
[http://dx.doi.org/10.1016/j.jff.2017.09.033]
[20]
Lu, Y-C.; Yin, L-T.; Chang, W-T.; Huang, J-S. Effect of Lactobacillus reuteri GMNL-263 treatment on renal fibrosis in diabetic rats. J. Biosci. Bioeng., 2010, 110(6), 709-715.
[http://dx.doi.org/10.1016/j.jbiosc.2010.07.006] [PMID: 20691633]
[21]
Abbasi, B.; Mirlohi, M.; Daniali, M.; Ghiasvand, R. Effects of probiotic soymilk on lipid panel in type 2 diabetic patients with nephropathy: A double-blind randomized clinical trial. Prog. Nutr., 2018, 20, 70-78.
[22]
Mazruei Arani, N.; Emam-Djomeh, Z.; Tavakolipour, H.; Sharafati-Chaleshtori, R.; Soleimani, A.; Asemi, Z. The effects of probiotic honey consumption on metabolic status in patients with diabetic nephropathy: a randomized, double-blind, controlled trial. Probiotics Antimicrob. Proteins, 2019, 11(4), 1195-1201.
[http://dx.doi.org/10.1007/s12602-018-9468-x] [PMID: 30218286]
[23]
Zheng, H.J.; Guo, J.; Wang, Q.; Wang, L.; Wang, Y.; Zhang, F.; Huang, W.J.; Zhang, W.; Liu, W.J.; Wang, Y. Probiotics, prebiotics, and synbiotics for the improvement of metabolic profiles in patients with chronic kidney disease: A systematic review and meta-analysis of randomized controlled trials. Crit. Rev. Food Sci. Nutr., 2020, 1-22.
[http://dx.doi.org/10.1080/10408398.2020.1740645] [PMID: 32329633]
[24]
McFarlane, C.; Ramos, C.I.; Johnson, D.W.; Campbell, K.L. Prebiotic, probiotic, and synbiotic supplementation in chronic kidney disease: a systematic review and meta-analysis. J. Ren. Nutr., 2019, 29(3), 209-220.
[http://dx.doi.org/10.1053/j.jrn.2018.08.008] [PMID: 30366767]
[25]
Jia, L.; Jia, Q.; Yang, J.; Jia, R.; Zhang, H. Efficacy of probiotics supplementation on chronic kidney disease: A systematic review and meta-analysis. Kidney Blood Press. Res., 2018, 43(5), 1623-1635.
[http://dx.doi.org/10.1159/000494677] [PMID: 30380555]
[26]
Vlachou, E.; Ntikoudi, A.; Govina, O.; Lavdaniti, M.; Kotsalas, N.; Tsartsalis, A.; Dimitriadis, G. Effects of Probiotics on Diabetic Nephropathy: A Systematic Review. Curr. Clin. Pharmacol., 2020, 15(3), 234-242.
[http://dx.doi.org/10.2174/1574884715666200303112753] [PMID: 32124701]
[27]
Liberati, A.; Altman, D.G.; Tetzlaff, J.; Mulrow, C.; Gøtzsche, P.C.; Ioannidis, J.P.; Clarke, M.; Devereaux, P.J.; Kleijnen, J.; Moher, D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann. Intern. Med., 2009, 151(4), W65-94.
[http://dx.doi.org/10.7326/0003-4819-151-4-200908180-00136] [PMID: 19622512]
[28]
Sterne, JA; Savović, J; Page, MJ; Elbers, RG; Blencowe, NS; Boutron, I RoB 2: a revised tool for assessing risk of bias in randomised trials. bmj., 2019, 366
[29]
Hozo, S.P.; Djulbegovic, B.; Hozo, I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med. Res. Methodol., 2005, 5(1), 13.
[http://dx.doi.org/10.1186/1471-2288-5-13] [PMID: 15840177]
[30]
Abbasi, B.; Ghiasvand, R.; Mirlohi, M. Kidney function improvement by soy milk containing Lactobacillus plantarum A7 in type 2 diabetic patients with nephropathy: a double-blinded randomized controlled trial. Iran. J. Kidney Dis., 2017, 11(1), 36-43.
[PMID: 28174351]
[31]
Mafi, A.; Namazi, G.; Soleimani, A.; Bahmani, F.; Aghadavod, E.; Asemi, Z. Metabolic and genetic response to probiotics supplementation in patients with diabetic nephropathy: a randomized, double-blind, placebo-controlled trial. Food Funct., 2018, 9(9), 4763-4770.
[http://dx.doi.org/10.1039/C8FO00888D] [PMID: 30113051]
[32]
Soleimani, A.; Zarrati Mojarrad, M.; Bahmani, F.; Taghizadeh, M.; Ramezani, M.; Tajabadi-Ebrahimi, M.; Jafari, P.; Esmaillzadeh, A.; Asemi, Z. Probiotic supplementation in diabetic hemodialysis patients has beneficial metabolic effects. Kidney Int., 2017, 91(2), 435-442.
[http://dx.doi.org/10.1016/j.kint.2016.09.040] [PMID: 27927601]
[33]
Miraghajani, M.; Zaghian, N.; Mirlohi, M.; Feizi, A.; Ghiasvand, R. The impact of probiotic soy milk consumption on oxidative stress among type 2 diabetic kidney disease patients: a randomized controlled clinical trial. J. Ren. Nutr., 2017, 27(5), 317-324.
[http://dx.doi.org/10.1053/j.jrn.2017.04.004] [PMID: 28579313]
[34]
Miraghajani, M.; Zaghian, N.; Dehkohneh, A.; Mirlohi, M.; Ghiasvand, R. Probiotic soy milk consumption and renal function among type 2 diabetic patients with nephropathy: a randomized controlled clinical trial. Probiotics Antimicrob. Proteins, 2019, 11(1), 124-132.
[http://dx.doi.org/10.1007/s12602-017-9325-3] [PMID: 28884306]
[35]
Thongprayoon, C.; Hatch, S.T.; Kaewput, W.; Sharma, K.; Ungprasert, P.; Wijarnpreecha, K. The effects of probiotics on renal function and uremic toxins in patients with chronic kidney disease; a meta-analysis of randomized controlled trials. J. Nephropathol., 2018, 7(3)
[http://dx.doi.org/10.15171/jnp.2018.25]
[36]
Tao, S.; Tao, S.; Cheng, Y.; Liu, J.; Ma, L.; Fu, P. Effects of probiotic supplements on the progression of chronic kidney disease: A meta-analysis. Nephrology (Carlton), 2019, 24(11), 1122-1130.
[http://dx.doi.org/10.1111/nep.13549] [PMID: 30561114]
[37]
Firouzi, S.; Haghighatdoost, F. The effects of prebiotic, probiotic, and synbiotic supplementation on blood parameters of renal function: A systematic review and meta-analysis of clinical trials. Nutrition, 2018, 51-52, 104-113.
[http://dx.doi.org/10.1016/j.nut.2018.01.007] [PMID: 29626749]
[38]
Zhang, Q.; Wu, Y.; Fei, X. Effect of probiotics on glucose metabolism in patients with type 2 diabetes mellitus: A meta-analysis of randomized controlled trials. Medicina (Kaunas), 2016, 52(1), 28-34.
[http://dx.doi.org/10.1016/j.medici.2015.11.008] [PMID: 26987497]
[39]
Yao, K.; Zeng, L.; He, Q.; Wang, W.; Lei, J.; Zou, X. Effect of probiotics on glucose and lipid metabolism in type 2 diabetes mellitus: a meta-analysis of 12 randomized controlled trials. Med. Sci. Monit., 2017, 23, 3044-3053.
[http://dx.doi.org/10.12659/MSM.902600] [PMID: 28638006]
[40]
Ardeshirlarijani, E.; Tabatabaei-Malazy, O.; Mohseni, S.; Qorbani, M.; Larijani, B.; Baradar Jalili, R. Effect of probiotics supplementation on glucose and oxidative stress in type 2 diabetes mellitus: a meta-analysis of randomized trials. Daru, 2019, 27(2), 827-837.
[http://dx.doi.org/10.1007/s40199-019-00302-2] [PMID: 31691101]
[41]
Samah, S.; Ramasamy, K.; Lim, S.M.; Neoh, C.F. Probiotics for the management of type 2 diabetes mellitus: A systematic review and meta-analysis. Diabetes Res. Clin. Pract., 2016, 118, 172-182.
[http://dx.doi.org/10.1016/j.diabres.2016.06.014] [PMID: 27388674]
[42]
Wang, L.; Shang, Q.; Guo, W.; Wu, X.; Wu, L.; Wu, L. Evaluation of the hypoglycemic effect of probiotics via directly consuming glucose in intestines of STZ-induced diabetic mice and glucose water-induced diabetic mice. J. Funct. Foods, 2020, 64, 103614.
[http://dx.doi.org/10.1016/j.jff.2019.103614]
[43]
Xu, B-H.; Sheng, J.; You, Y-K.; Huang, X-R.; Ma, R.C.W.; Wang, Q.; Lan, H.Y. Deletion of Smad3 prevents renal fibrosis and inflammation in type 2 diabetic nephropathy. Metabolism, 2020, 103, 154013.
[http://dx.doi.org/10.1016/j.metabol.2019.154013] [PMID: 31734275]
[44]
Salehipour, Z.; Haghmorad, D.; Sankian, M.; Rastin, M.; Nosratabadi, R.; Soltan Dallal, M.M.; Tabasi, N.; Khazaee, M.; Nasiraii, L.R.; Mahmoudi, M. Bifidobacterium animalis in combination with human origin of Lactobacillus plantarum ameliorate neuroinflammation in experimental model of multiple sclerosis by altering CD4+ T cell subset balance. Biomed. Pharmacother., 2017, 95, 1535-1548.
[http://dx.doi.org/10.1016/j.biopha.2017.08.117] [PMID: 28946394]
[45]
Bäckhed, F.; Fraser, C.M.; Ringel, Y.; Sanders, M.E.; Sartor, R.B.; Sherman, P.M.; Versalovic, J.; Young, V.; Finlay, B.B. Defining a healthy human gut microbiome: current concepts, future directions, and clinical applications. Cell Host Microbe, 2012, 12(5), 611-622.
[http://dx.doi.org/10.1016/j.chom.2012.10.012] [PMID: 23159051]
[46]
Kaur, L; Gordon, M; Baines, PA; Iheozor‐Ejiofor, Z; Sinopoulou, V; Akobeng, AK Probiotics for induction of remission in ulcerative colitis. Cochrane Database of Systematic Reviews., 2020, 3(3), CD005573.
[http://dx.doi.org/10.1002/14651858.CD005573.pub3]

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