The Efficacy Of Probiotics On Diabetes Mellitus And Metabolic Syndrome:A Systematic Review And Meta-analysis

Background & Objective: At present,the incidence of both diabetes mellitus and metabolic syndrome are increasing day by day.In addition,the complications resulted from them are influencing the quality of life and survival time severely.Many studies have indicated that probiotics may benefit the improving of DM and MS.However,their study results and conclusions still remains controversy.Thus,the present systematic review and meta-analysis was designed to comprehensively evaluate and analyze the efficacy of probiotics on DM and MS.Methods: We searched PubMed,Embase,Cochrane Library,Web of Science,CNKI,CBM and WanFang Database to October,2018.We also hand searched the citation lists of included studies and previously identified systematic reviews to identify further relevant trials.Our primary outcome variables included glucose and HbA1 c and insulin.The secondary outcomes included blood lipid indicators.The pooled std.mean difference(SMD)with its 95% confidence interval(CI)was used to evaluate and analyze the efficacy of probiotics on DM and MS.We also performed subgroup and sensitivity analysis to evaluate the effect of probiotics on DM and MS further.Results: 25 randomized,placebo-controlled studies(N=1617 participants.764 consuming probiotics,853 not consuming probiotics)were included for analysis.Our analysis results indicated that probiotics could significantly reduce the level of glucose,insulin and HbA1 c of patients with DM,with pooled SMDs of-0.78 [95%CI-1.22,-0.33;P=0.0006]、-0.84 [95%CI-1.29,-0.39;P=0.0003] and-0.49 [95%CI-0.67,-0.30;P<0.00001] respectively.Additionally,we also found that the level of HDL of patients with DM experienced a significant reduction in probiotics group,with the pooled SMD of 0.83 [95%CI 0.06,1.61;P=0.04].However,for MS,significant improvement was only observed in insulin [SMD-0.61 95%CI-1.21,-0.01;P=0.04].Conclusions: This meta-analysis indicated that probiotics may have significant efficacy in reduction of glucose,insulin and HbA1 c for patients with diabetes.In addition,probiotics could also improve the level of HDL of patients with diabetes.However,for MS,no significant improvement was found except in insulin.