title: Probiotic supplementation in diabetic hemodialysis patients has beneficial metabolic effects.
abstract: This study determined the effects of probiotic supplementation on glycemic control, lipid concentrations, biomarkers of inflammation and oxidative stress in 60 diabetic patients on hemodialysis in a parallel randomized double-blind placebo-controlled clinical trial. Participants were initially matched based on sex, duration of dialysis and diabetes, body mass index and age. Subsequently, they were randomly divided into two groups to take either a capsule containing the probiotics Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum or placebo for 12 weeks. Based on three-day dietary records throughout the trial, there was no significant change in dietary macro- and micro-nutrients or total dietary fiber to confound results. After the 12 weeks, analysis of patients who received probiotic supplements compared with the placebo showed they had significantly decreased fasting plasma glucose (-22.0 vs. +6.6 mg/dl), serum insulin (-6.4 vs. +2.3 μIU/ml), homeostasis model of assessment-estimated insulin resistance (-2.9 vs. +2.5), homeostasis model of assessment-estimated beta-cell function (-14.1 vs. +6.1) and HbA1c (-0.4 vs. -0.1%,), and improved quantitative insulin sensitivity check index (+0.03 vs. -0.02). Additionally, compared with the placebo, probiotic supplementation resulted in significant reductions in serum high-sensitivity C-reactive protein (-1933 vs. +252 ng/ml), plasma malondialdehyde (-0.3 vs. +1.0 μmol/l), subjective global assessment scores (-0.7 vs. +0.7) and total iron binding capacity (-230 vs. +33 μg/dl), and a significant increase in plasma total antioxidant capacity (+15 vs. -88 mmol/l). Thus, probiotic supplementation for 12 weeks among diabetic hemodialysis patients had beneficial effects on parameters of glucose homeostasis, and some biomarkers of inflammation and oxidative stress.
authors.affiliation: Department of Internal Medicine, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Soleimani
authors.affiliation: Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran.
authors.forename: Malihe
authors.initials: M
authors.lastname: Zarrati Mojarrad
authors.affiliation: Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran.
authors.forename: Fereshteh
authors.initials: F
authors.lastname: Bahmani
authors.affiliation: Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Taghizadeh
authors.affiliation: Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ramezani
authors.affiliation: Faculty Member of Science Department, Science Faculty, Islamic Azad University, Tehran Central Branch, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Tajabadi-Ebrahimi
authors.affiliation: Department of Microbiology, Science Faculty, Islamic Azad University, Arak Branch, Arak, Iran.
authors.forename: Parvaneh
authors.initials: P
authors.lastname: Jafari
authors.affiliation: Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Esmaillzadeh
authors.affiliation: Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran. Electronic address: asemi_r@yahoo.com.
authors.forename: Zatollah
authors.initials: Z
authors.lastname: Asemi
mesh_terms: D000328:Adult; D000368:Aged; D000069985:Bifidobacterium bifidum / Q000254:growth & development; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000097:blood / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D000069196:Gastrointestinal Microbiome; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007333:Insulin Resistance; D007492:Iran; D007779:Lactobacillus acidophilus / Q000254:growth & development; D007780:Lacticaseibacillus casei / Q000254:growth & development; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D019936:Probiotics / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D018836:Inflammation Mediators; D008055:Lipids; C517652:hemoglobin A1c protein, human
keywords: hemodialysis; metabolic status; probiotic supplementation