A Meta-analysis of Randomized Controlled Trials of the Effect of Probiotic Food or Supplement on Glycemic Response and Body Mass Index in Patients with Type 2 Diabetes, Updating the Evidence.

BACKGROUND: To investigate the effects of probiotics on glucose metabolism and body mass index (BMI), and compare the efficacy of probiotic food with the probiotic supplement in patients with type 2 diabetes mellitus using a meta-analysis of randomized, controlled trials. METHODS: Online databases Embase, Web of Science, and PubMed were searched until November 2019 to identify eligible articles. Fourteen trials were included. RESULTS: Probiotic consumption reduced fasting plasma glucose (FPG) (SMD=-0.38, 95% CI: -0.76 to 0.01), glycosylated hemoglobin (HbA1c) (SMD=-0.64, 95% CI: -0.91 to -0.38), fasting insulin concentration (SMD=-0.48, 95% CI, -0.81 to -0.15), HOMA-IR (SMD=-1.01, 95% CI, -1.51 to -0.52), and BMI (SMD=-0.02, 95%CI, -0.17 to 0.13) in intervention groups compared with control groups. Subgroup analysis was conducted to trials with probiotic foods and probiotic supplements. Both of probiotic foods (SMD: -0.65, 95% CI: -1.04 to -0.26; SMD: -1.17, 95% CI: -2.14 to -0.20, respectively) and supplements (SMD: -0.64, 95% CI: -1.01 to -0.27; SMD: -0.98, 95% CI: -1.55 to -0.40, respectively) made significant reduction in HbA1c and HOMA.IR. Meta-analysis of trials with probiotic foods found non-significant changes in FBG and fasting insulin concentration (SMD: 0.11, 95% CI: -0.52 to 0.75; SMD: -0.14, 95% CI: -0.48 to 0.20, respectively); however the changes in trials with probiotic supplements were significant (SMD: -0.73, 95% CI: -1.22 to -0.23; SMD: -0.57, 95% CI: -0.97 to -0.17, respectively). Probiotic foods cause a non-significant raise in BMI (SMD: 0.23, 95% CI: -0.03 to 0.49); however, meta-analysis of trials with probiotic supplements found a non-significant reduction in BMI (SMD: -0.13, 95% CI: -0.31 to 0.04). CONCLUSION: The present meta-analysis suggests that consuming probiotics could improve glucose metabolism and affect body weight, with a potentially greater effect when probiotics are used as supplements.

Effects of Cornus mas Fruit Hydro-Methanolic Extract on Liver Antioxidants and Histopathologic Changes Induced by Cisplatin in Rats.

Cornelian cherry (Cornus mas) is a valuable source of phenolic antioxidants. The present study was aimed to investigate whether Cornus mas fruit hydro-methanolic extract (CMFE) can modulate the cisplatin-induced changes in liver antioxidant enzymes and histological structure. Forty Wistar rats were divided into a control group, cisplatin (Cis) group, CMFE group, CMFE 300 + Cis group, and the CMFE 700 + Cis group. After the intervention, blood and tissue samples were taken for biochemical and histopathological analysis. Cis caused reduction in the activity of liver antioxidant enzymes including SOD, GPx, TAC, and CAT and increased that of MDA. Moreover, exposure to Cis caused a reduction in serum level of AST, ALT, and ALP and a rise in serum level of GGT. Oral administration of CMFE for 16 days in the two different dosages at 300 and 700 mg/kg improved the Cis-induced changes of liver enzymes activity and serum enzymes level. Evaluating the histological structure of liver tissue, it was found that treatment by CMFE could ameliorate the Cis-induced changes to near normal histology. The results showed antioxidant and phenol contents in Cornus mas fruit could improve Cis-induced oxidative stress and liver histologic changes in rats.

Curcumin and Gastric Cancer: a Review on Mechanisms of Action.

BACKGROUND AND AIM: Gastric cancer, as the fourth cause of death in women and third in men with malignant tumors, is now threatening people's lives worldwide. Natural anti-tumor products are potential anti-cancer agents with fewer by-effects. Curcumin, an herbal product, has been used as a cosmetic and food additive and as a traditional herbal medicine for thousands of years in Asian countries. Several studies revealed that curcumin can inhibit the invasion and proliferation of gastric cancer cells. This paper analyzes existing data from animal and in vitro studies in order to highlight the mechanisms of therapeutic effects of curcumin in gastric cancer. METHODS: Science Direct and Pub Med databases were searched by using "curcumin" and "gastric cancer" for searching the studies aiming the application of curcumin and the beneficial effects of curcumin in gastric cancer control and treatment. RESULTS: These results suggested that curcumin can suppress multiple signaling pathways and inhibit cancer cell proliferation, invasion, metastasis, and angiogenesis. According to the studies, curcumin can inhibit gastric cancer by several mechanisms including decreasing proliferation, inducing apoptosis, and reducing chemo-resistance in gastric cancer cells. CONCLUSIONS: The findings of present paper provided novel perceptions about the mechanisms of curcumin action in gastric cancer cell growth inhibition and its therapeutic strategies for gastric cancer control. So, curcumin could be considered as a novel therapeutic strategy to control gastric cancer cell growth.

Probiotic assisted weight management as a main factor for glycemic control in patients with type 2 diabetes: a randomized controlled trial.

OBJECTIVES: To evaluate the effect of Lactobacillus casei 01 on dietary intake, body weight, and glycemic control in patients with T2DM. METHOD: Forty patients with T2DM (n = 20 for each group) were assigned into two groups in present trial. The patients in the probiotic group received a daily capsule containing a minimum of 108 CFU of L. casei 01 for 8 week. The placebo group took capsules filled with maltodextrin for the same time period. Dietary intake questionnaires and anthropometric measurements were collected, and the participants were assessed by an endocrinologist at baseline and at the end of the trial. RESULTS: Lactobacillus casei 01 supplementation significantly decreased total energy, carbohydrate, fat, and protein intake compared with placebo (p = 0.001, p = 0.002, p = 0.009, p = 0.001; respectively). Moreover weight, BMI, and waist circumference were significantly decreased in intervention group compared with placebo group (p < 0.001; p < 0.001; p = 0.029; respectively). In comparison with placebo group serum fetuin-A level, fasting blood sugar, insulin concentration, and insulin resistance were significantly decreased (p = 0.023, p =0.013, p = 0.028; p = 0.007; respectively), and serum SIRT1 level was significantly increased (p = 0.040) in intervention group. CONCLUSIONS: Lactobacillus casei 01 supplementation affected dietary intake and body weight in a way that improved fetuin-A and SIRT1 levels and glycemic response in subjects with T2DM. Affecting the fetuin-A and SIRT1 levels introduces a new known mechanism of probiotic action in diabetes management.

The Effects of Lactobacillus casei on Glycemic Response, Serum Sirtuin1 and Fetuin-A Levels in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial

Background: Type 2 diabetes mellitus (T2DM) is related to the gut microbiota with numerous molecular mechanisms. Modulating the gut microbiota by probiotics could be effective in management of T2DM. The aim of the present trial was to evaluate the effect of Lactobacillus casei on glycemic control and serum sirtuin1 (SIRT1) and fetuin-A in patients with T2DM. Methods: Forty patients with T2DM (n = 20 for each group) were divided into intervention (probiotic) and placebo groups. The intervention group received a daily capsule containing 108 cfu of L. casei for eight weeks. The patients in placebo group took capsules containing maltodextrin for the same time duration. Anthropometric measurements, dietary intake questionnaires, and blood samples were collected, and the patients were assessed by an endocrinologist at the beginning and at the end of the trial. Results: Fasting blood sugar, insulin concentration, and insulin resistance significantly decreased in probiotic group compared with placebo group (-28.32 [-50.23 to -6.41], 0.013; -3.12 [-5.90 to -0.35], 0.028; -32.31 [-55.09 to -9.54], 0.007, respectively). Moreover, HbA1c reduced after intervention, but the reduction was not significant (-0.45 [-0.96 to 0.05], 0.077). In comparison with placebo, the L. casei supplementation significantly increased SIRT1 and decreased fetuin-A levels at the end of the trial (0.52 [0.026 to 1.02], 0.040; -17.56 [-32.54 to -2.58], 0.023, respectively). Conclusion: L. casei supplementation affected SIRT1 and fetuin-A levels in a way that improved glycemic response in subjects with T2DM. Affecting the SIRT1 and fetuin-A levels introduces a new known mechanism of probiotic action in diabetes management.

Role of vitamin D deficiency in systemic lupus erythematosus incidence and aggravation.

Vitamin D is one of the main groups of sterols; playing an important role in phospho-calcic metabolism. The conversion of 7-dehydrocholesterol to pre- vitamin D3 in the skin, through solar ultraviolet B radiation, is the main source of vitamin D. Since lupus patients are usually photosensitive, the risk of developing vitamin D deficiency in is high in this population. Although evidences showed the connotation between systemic lupus erythematosus (SLE) and vitamin D through which SLE can lead to lower vitamin D levels, it is also important to consider the possibility that vitamin D deficiency may have a causative role in SLE etiology. This paper analyzes existing data from various studies to highlight the role of vitamin D deficiency in SLE occurrence and aggravation and the probable efficacy of vitamin D supplementation on SLE patients. We searched "Science Direct" and "Pub Med" using "Vitamin D" and "SLE" for finding the studies focusing on the association between vitamin D deficiency and SLE incidence and consequences. Evidences show that vitamin D plays an important role in the pathogenesis and progression of SLE and vitamin D supplementation seems to ameliorate inflammatory and hemostatic markers; so, can improve clinical subsequent.

The Future of Diabetes Management by Healthy Probiotic Microorganisms.

BACKGROUND: Diabetes mellitus, a condition of multifactorial origin, is related to the intestinal microbiota by numerous molecular mechanisms. Controlling the vast increase in the prevalence of diabetes needs a natural and safe solution. Probiotics, known as live microorganisms that exert health benefits to the host, have anti-diabetic property. OBJECTIVE: This review will highlight the current evidences in probiotic effectiveness and future prospects for exploring probiotic therapy in the prevention and control of diabetes. METHODS: We searched Pub Med and Science Direct by using "Probiotics" and "Diabetes" for searching the studies aiming the application of probiotics and the beneficial effects of probiotics in diabetes prevention and control. RESULTS: It has been shown that probiotics can increase insulin sensitivity and reduce autoimmune responses by modulating intestinal microbiota and decreasing the inflammatory reactions and oxidative stress. Recent evidences show that probiotics influences the host through modulating intestinal permeability and mucosal immune response, manipulating eating behaviors by appetite-regulating hormones and controlling gut endocannabinoid (eCB) system that is believed to be associated with inflammation and diabetes. Moreover, modulating the intestinal microbiota by probiotics controls host metabolism by affecting energy extraction from food and by biochemically converting molecules derived from the host or from gut microbes themselves. CONCLUSION: Experimental and clinical evidences support the hypothesis that the modulation of the gut microbiota by probiotics could be effective in prevention and management of diabetes.