The Roles of Probiotics in the Gut Microbiota Composition and Metabolic Outcomes in Asymptomatic Post-Gestational Diabetes Women: A Randomized Controlled Trial
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participant Recruitment
- (1)
- Impaired fasting glucose (IGT), FBG level ≥ 6.1 mmol/L and 2-h post-prandial (2HPP) level < 7.8 mmol/L.
- (2)
- Impaired glucose tolerance (IGT), FBG level < 6.1 mmol/L and 2HPP level ≥ 7.8 mmol/L.
- (3)
- Combination of IFG and IGT, FBG level between 6.1–6.9 mmol/L and 2HPP level between 7.8–11.0 mmol/L.
2.3. Intervention and Compliance
2.4. Dietary Intake and Physical Activity Assessments
2.5. Outcomes Measurements
2.5.1. Anthropometric and Blood Pressure Measurements
2.5.2. Biochemical Analysis
2.5.3. Gut Microbial Analysis
2.5.4. Functional Prediction Based on 16S rRNA Gene Data
2.6. Sample Size
2.7. Randomization and Blinding
2.8. Statistical Analysis
3. Results
3.1. Participant Recruitment and Flow
3.2. Baseline Characteristics of Participants
3.3. Changes in Dietary Habits and Physical Activity Levels after the 12-Week Intervention
3.4. Outcomes and Estimation
3.4.1. Changes in Primary Outcomes
3.4.2. Changes in Anthropometric Measurements Outcomes
3.4.3. Changes in Lipid Outcomes
3.4.4. Changes in Relative Abundance of Gut Microbial Compositions
3.4.5. Changes in Gut Microbial α Diversity
3.4.6. Changes in Gut Microbial β Diversity
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Probiotics (n = 66) | Placebo (n = 66) | p-Value |
---|---|---|---|
Age (years) | 34.85 ± 4.25 | 34.27 ± 4.79 | 0.487 |
Pre-pregnancy BMI (kg/m2) | 28.56 ± 5.10 | 27.12 ± 5.52 | 0.122 |
Ethnicity, n (%) | 1.000 # | ||
Malay | 60 (90.9) | 60 (90.9) | |
Non-Malay | 6 (9.1) | 6 (9.1) | |
Education level, n (%) | 0.059 # | ||
Secondary | 15 (22.7) | 26 (39.4) | |
Tertiary | 51 (77.3) | 40 (60.6) | |
Number of children | 3 ± 1 | 3 ± 1 | 0.813 |
Family history of T2DM, n (%) | 52 (78.8) | 40 (60.6) | 0.037 #* |
Received hypoglycemic agents in pregnancy, n (%) | 29 (43.9) | 26 (39.4) | 0.724 # |
Exclusive breastfeeding, n (%) | 30 (45.5) | 25 (37.9) | 0.480 # |
Postpartum OGTT assessment, n (%) | |||
Frequency of postpartum GI, n (%) | 30 (45.5) | 31 (47.0) | 1.000 # |
Pre-intervention assessment | |||
Months after delivery | 4.08 ± 1.09 | 4.12 ± 1.07 | 0.809 |
Macronutrient intake | |||
Total energy intakes (kcal/day) | 1600.82 ± 341.31 | 1606.88 ± 319.96 | 0.916 |
Carbohydrate (% total kcal) | 58.2 ± 7.9 | 56.0 ± 6.9 | 0.095 |
Fat (% total kcal) | 33.9 ± 4.7 | 32.3 ± 13.1 | 0.056 |
Proteins (% total kcal) | 16.8 ± 2.4 | 16.1 ± 2.5 | 0.116 |
Cholesterol intakes (mg/day) | 224.05 ± 106.15 | 215.46 ± 125.40 | 0.672 |
Total dietary fiber (g/day) | 6.45 ± 4.29 | 4.65 ± 2.27 | 0.003 ** |
Physical activities (minutes/week) | |||
Commuting | 56.62 ± 49.87 | 62.05 ± 55.30 | 0.555 |
Leisure-time activities | 40.89 ± 48.61 | 32.50 ± 39.78 | 0.286 |
Household activities | 1491.71 ± 559.01 | 1520.99 ± 672.38 | 0.786 |
Activities at work | 1470.98 ± 823.99 | 1230.68 ± 935.24 | 0.120 |
Total average 1-week physical activities | 3060.21 ± 640.84 | 2846.21 ± 709.51 | 0.071 |
Anthropometric measurements | |||
BMI (kg/m2) | 29.96 ± 4.67 | 27.87 ± 5.79 | 0.024 * |
Waist circumference (cm) | 93.99 ± 10.39 | 89.01 ± 9.78 | 0.005 * |
Overweight/Obese, n (%) | 64 (97.0) | 55 (83.3) | 0.016 #* |
Systolic blood pressure (mmHg) | 115.74 ± 11.77 | 116.41 ± 12.77 | 0.756 |
Diastolic blood pressure (mmHg) | 79.47 ± 10.97 | 78.50 ± 10.48 | 0.605 |
Biochemical outcomes | |||
FBG (mmol/L) | 5.36 ± 1.14 | 5.00 ± 0.95 | 0.056 |
HbAIc (%) | 5.66 ± 0.66 | 5.66 ± 0.56 | 0.944 |
Total cholesterol (mmol/L) | 4.91 ± 0.70 | 5.12 ± 0.85 | 0.103 |
Triglycerides (mmol/L) | 1.07 ± 0.77 | 1.26 ± 0.75 | 0.082 |
hs-CRP (mg/L) | 5.05 ± 3.50 | 3.76 ± 3.03 | 0.026 * |
Biomarkers | Probiotics (n = 15) | Placebo (n = 15) | p-Value |
---|---|---|---|
Fasting serum insulin (μIU/mL) | 13.99 (54.43) | 13.16 (51.45) | 0.852 |
HOMA-IR | 3.05 (18.37) | 3.74 (14.45) | 0.852 |
Fasting active GLP-1 (pmol/L) | 0.00 (1.25) | 0.00 (0.93) | 0.909 |
Interleukin-1β (pg/mL) | 0.13 (0.01) | 0.13 (0.04) | 0.868 |
Interleukin-6 (pg/mL) | 0.26 (0.53) | 0.29 (0.43) | 0.820 |
Interleukin-8 (pg/mL) | 0.65 (1.54) | 0.80 (0.77) | 0.852 |
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Hasain, Z.; Raja Ali, R.A.; Ahmad, H.F.; Abdul Rauf, U.F.; Oon, S.F.; Mokhtar, N.M. The Roles of Probiotics in the Gut Microbiota Composition and Metabolic Outcomes in Asymptomatic Post-Gestational Diabetes Women: A Randomized Controlled Trial. Nutrients 2022, 14, 3878. https://doi.org/10.3390/nu14183878
Hasain Z, Raja Ali RA, Ahmad HF, Abdul Rauf UF, Oon SF, Mokhtar NM. The Roles of Probiotics in the Gut Microbiota Composition and Metabolic Outcomes in Asymptomatic Post-Gestational Diabetes Women: A Randomized Controlled Trial. Nutrients. 2022; 14(18):3878. https://doi.org/10.3390/nu14183878
Chicago/Turabian StyleHasain, Zubaidah, Raja Affendi Raja Ali, Hajar Fauzan Ahmad, Ummul Fahri Abdul Rauf, Seok Fang Oon, and Norfilza Mohd Mokhtar. 2022. "The Roles of Probiotics in the Gut Microbiota Composition and Metabolic Outcomes in Asymptomatic Post-Gestational Diabetes Women: A Randomized Controlled Trial" Nutrients 14, no. 18: 3878. https://doi.org/10.3390/nu14183878