Probiotic supplementation for management of cardiovascular risk factors in adults with type II diabetes: A systematic review and meta-analysis

Summary Background & aims The effectiveness of probiotics in control of hypertension and dyslipidemia in diabetic patients remains unclear. Therefore, we systematically reviewed relevant data to elucidate the effects of probiotics on blood pressure and lipid profile of type 2 diabetic patients. Methods We searched PubMed, ISI Web of Knowledge, Scopus, The Cochrane Library, ClinicalTrials.gov , ProQuest Dissertations and Theses databases until May 2016. The primary outcomes were systolic blood pressure (SBP) and diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG). Other biochemical response and adverse effects were considered as secondary outcomes. Data was extracted from included studies and pooled in meta-analysis whenever possible (both standardized mean difference (SMD) analysis and weighted mean difference (WMD) analysis were performed). Results Eleven eligible randomized controlled trial (n = 641) were identified. Pooling data from these trials demonstrated probiotic consumption significantly decreased SBP (WMD, −3.28 mmHg; 95% confidence interval [CI], −5.38 to −1.18), DBP (WMD, −2.13 mmHg; 95% CI, −4.5 to 0.24), LDL-C (WMD, 8.32 mg/dl; 95% CI, −15.24 to −1.4), TC (WMD, −12.19 mg/dl; 955 CI −17.62 to −6.75) and TG (WMD, −24.48 mg/dl; 95% CI, −33.77 to −11.18) in type 2 diabetic patients compared with placebo. The methodological quality varied across trials included in this study. Conclusion This systematic review suggests probiotics supplementation may be helpful for control of dyslipidemia and hypertension in type 2 diabetic patients. Conducting more trails with large sample size and long follow-up time still is necessary to develop clinical practice guidelines for management of cardiovascular risk factors in patient with type 2 diabetes.