Effect of Synbiotic Supplementation on Metabolic Status، Serum Apelin Levels and Anthropometric Indexes in Patients With Polycystic Ovary Syndrome

Abstract

Background: Polycystic ovary syndrome is one of the most prevalent endocrine diseases in women. This study was amid to investigate the effects of synbiotic supplementation on serum glycemic indexes, lipids, serum apelin levels and obesity values in patients with PCOS. Materials and Methods: A total of 68 obese or overweight patients with PCOS aged 20-44 years old were participated in a randomized double-blinded placebo controlled clinical trial. Subjects were assigned into two groups receiving synbiotic (n = 34) and placebo group (n = 34). The intervention group received one synbiotic capsules (500 mg) containing (Lactobacillus, Bifidobacterium and Streptococcus thermophilus) 109 CFU along with the prebiotic fructooligosaccharide and the placebo group received one placebo capsule for 8 weeks. Fasting blood specimens, anthropometric measurements and dietary intake data were gathered at the outset and at the finale of the study. Biochemical evaluations including glycemic indexes (fasting blood glucose, insulin and insulin resistance), serum lipids (triglycerides, cholesterol, high-density lipoprotein and low-density lipoprotein) and serum apelin were performed before and after the intervention. The information was analyzed by independent t-test, paired t-test, analysis of covariance and chi-square test. Results: There were no significant differences in terms of physical activity, anthropometric indices, lipids profile and serum apelin levels between the two groups at the beginning of the study. Significant differences were seen in mean of daily energy and carbohydrate intakes , serum insulin and homeostatic model assessment for insulin resistance between the two groups at baseline( P <0.05).Differences in the levels of physical activity and dietary intake at the end of the study were not significant between the two groups. The means of serum fasting glucose , insulin and homeostatic model assessment for insulin resistance in the synbiotic group significantly decreased compared to the placebo group at the end of the study (P=0.02, P=0.001 and P=0.002, respectively). Serum high-density lipoprotein cholesterol levels significantly increased in the synbiotic group compared to the placebo group at the end of the study (P = 0.02). No significant changes were seen in serum total cholesterol, triglyceride, low-density lipoprotein cholesterol, and apelin levels between two groups at the end of the trial (P >0.05). Significant decreases in weight (P = 0.02), body mass index (P = 0.02), waist circumference (P = 0.01), hip circumference (P = 0.02) and waist to height ratio (P=0.02) were observed in the synbiotic group compared to placebo group at the final of study. Changes in other anthropometric variables were not significant between the two groups. Conclusion: Synbiotic supplementation improved glycemic indexes, lipids profile and obesity values in women with PCOS and seems to be effective in controlling the complications of this disease. Changes in serum apelin levels were not significant in this study. Other studies are suggested to determine the effect of synbiotics on serum adipokines in women with PCOS.