Effect of probiotic yoghurt on plasma glucose in overweight and obese pregnant women: a randomized controlled clinical trial
Effect of probiotic yoghurt on plasma glucose in overweight and obese pregnant women: a randomized controlled clinical trial
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DOI：
10.1007/s00394-019-01900-1
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发表时间：
2020-02-01
影响因子：
5
通讯作者：
Mohammad-Alizadeh-Charandabi, Sakineh
中科院分区：
文献类型：
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作者：
Asgharian, Hanieh;Homayouni-Rad, Aziz;Mohammad-Alizadeh-Charandabi, Sakineh
前言目前仅有一些证据表明益生菌能有效预防妊娠期高血糖。本试验研究了含有嗜酸乳杆菌La5和乳酸双歧杆菌BB12的益生菌酸奶对妊娠期无糖尿病的超重和肥胖妇女的母体血糖(主要结果)和一些母婴并发症(次要结果)的影响。方法采用分层随机区组设计，将孕前或孕早期体重指数为25，孕22周空腹血糖92 mg/dl的孕妇分为益生菌组和常规酸奶组，从孕24周开始至分娩，每天服用酸奶100g。对这些妇女和她们的婴儿进行跟踪，直到出生后1个月。结果在每组中，每65名妇女中就有一名发生宫内胎儿死亡，并且没有对其他结局进行分析。益生菌组和普通酸奶组的平均体重指数分别为29.2(SD 3.3)和30.3(SD 4.1)。治疗开始4周后，益生菌组的血糖水平在空腹(根据BMI类别调整的平均差值)和基线空腹血糖(-4.0 mg/dl；95%可信区间-6.9，-1.1)和2小时OGTT(-13.9；-22.8，-5.0)时显著低于传统酸奶组。然而，在1h的OGTT中，差异没有统计学意义(-9.8；-20.6，0.9)。此外，益生菌组在出生后3-5天婴儿胆红素水平显著低于对照组(-2.2 mg/dl；-3.3，-1.2)。在妊娠期糖尿病风险(6比11；优势比0.5；0.2，1.5)、早产(3比8；0.3；0.1，1.2)和其他母婴结局方面，两组之间没有统计学上的差异。结论益生菌对超重、肥胖孕妇的糖代谢有一定的改善作用。然而，还需要进一步的研究来判断这种影响的临床意义。
Introduction There is only some evidence about effectiveness of probiotics for preventing gestational hyperglycaemia. This trial examined the effects of probiotic yoghurts containing Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 on maternal plasma glucose (primary outcome) and on some maternal and infant complications (secondary outcomes) in overweight and obese women with no diabetes in pregnancy. Methods Using stratified block randomization, women with pre- or early-pregnancy BMI >= 25 and fasting plasma glucose < 92 mg/dl at 22 weeks of gestation were assigned into probiotic or conventional yoghurt group, consuming 100 g/day from 24 weeks of gestation until delivery. The women and their infants were followed up until 1 month after birth. Results In each group, one out of 65 women had intra-uterine foetal death and were not analysed for other outcomes. The mean BMI was 29.2 (SD 3.3) in probiotic and 30.3 (SD 4.1) in conventional yoghurt group. Four weeks after initiation of the treatment, plasma glucose levels were significantly lower in the probiotic than in conventional yoghurt group at fasting (mean difference adjusted for the BMI category) and baseline FPG (- 4.0 mg/dl; 95% confidence interval - 6.9, - 1.1) and 2-h OGTT (- 13.9; - 22.8, - 5.0). At the 1-h OGTT, however, the difference was not statistically significant (- 9.8; - 20.6, 0.9). Further, there was a significantly lower infant bilirubin level in the probiotic group on days 3-5 after birth (- 2.2 mg/dl; - 3.3, - 1.2). There were not statistically significant differences between the groups regarding the risk of gestational diabetes (6 vs 11; odds ratio 0.5; 0.2, 1.5), preterm delivery (3 vs 8; 0.3; 0.1, 1.2), and other maternal and infant outcomes. Conclusion The probiotics supplementation has some beneficial effects on glucose metabolism of overweight and obese pregnant women. Nevertheless, further studies are required to judge the clinical significance of such effects.