The effect of synbiotic supplementation on lipid profile, glycemic control and hs-CRP in women with gestational diabetes mellitus

Abstract

Objective: Gestational diabetes mellitus (GDM) is defined as the type of glucose intolerance that develops in the second and third trimester of pregnancy. Based on available reports, the important role of gut microbiota in the management of diabetes is increasing; therefore, this randomized clinical trial assessed the effects of synbiotic supplementation on glycemic status, lipid profiles and hs-CRP among women with GDM. Material and Methods: This study was conducted among 90 pregnant women diagnosed with GDM, who referred to the Diabetes East Health Center in Ahwaz. Individuals were randomly allocated into 2 groups of synbiotic (n=45) and placebo (n=45) asked to receive 1 capsule per day which contained 109 CFU of Lactobacillus probiotic strains and 38.5 mg of fructooligo-saccharides (FOS) as prebiotic substance, for 6 weeks. Nutrient intakes were estimated using 24-h dietary intakes as well as a 3-day dietary recall at the beginning and at the end of the study. Food intake, anthropometric measurements containing weight, BMI and hip circumference as well as biochemical factors including Fasting plasma glucose (FPG), serum insulin, homeostasis model assessment-insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), total cholesterol (TC)and high-sensitivity c-reactive protein (hs-CRP) were assesed at the beginning and at the end of the study. SPSS software was used for data analyzing evaluating independent sample t-test and ANCOVA test. Results: Within group comparisons showed significant increase in BMI for both synbiotic and placebo groups, at the end of the study, but this increase was not significant in between group comparisons (P > 0.05). In terms of energy, protein and fat intakes there were significant differences between two groups at the beginning of the study (P < 0.05). This comparison also showed that there were no significant differences for the measures of other macro and micronutrients (P > 0.05). In addition, according to dietary between group comparisons of patients, significant decrease in fat intakes was reported after the synbiotic supplementation (P < 0.05). Furthermore, statistically significant differences were observed in carbohydrate and fiber intakes within the synbiotic group (P < 0.05). Synbiotic consumption led to significant within group increases in HDL-C in synbiotic group (P < 0.05), though, this increase was not significant between groups. Moreover, significant within group increases in TC and TG levels for both synbiotic and placebo groups (P < 0.05), meanwhile, between group comparisons was not significant. In addition, a significant within group increase was found in LDL-C levels in placebo group (P < 0.05). Furthermore, according to within group comparisons, slight decreases in FPG, HOMA-IR and slight increses in serum insulin levels were reported in synbiotic group, after the intervention, though these differences were not statically significant. Also, synbiotic intervention did not affect other indices such as insulin sensitivity and hs-CRP. Conclusion: Synbiotic supplementation containing 109 CFU of different strains of Lactobacillus had no significant effect on lipid profiles, glycemic indices and hs-CRP in women with gestational diabetes mellitus. Due to the potential effect of this supplement on increasing HDL-C, further studies are needed.