Associations between vitamin D, systemic inflammation and synbiotic supplementation: secondary study from a randomized clinical trial



To evaluate the effects of a synbiotic substance on the vitamin D (VitD) status of elderly, and its association with systemic inflammation. Research question: Is synbiotic supplementation able to improve the VitD status?


This is a secondary study from a randomized, parallel, double-blind controlled clinical trial, lasting 24 weeks, with 49 participants randomly assigned into two groups; the S-group received a synbiotic substance, and the P-group received placebo. Participants were evaluated at baseline and at the end of the study for body fat percentage (% fat); plasma levels of interleukin-10 (IL-10) and interleukin-6 (IL-6), obtaining the IL-10/IL-6 ratio, named anti-inflammatory index (AII); plasma markers of gut permeability; and plasma VitD concentration.


None of the variables investigated presented significant differences between groups. However, the delta-value of VitD showed to be positive in S-group (which means that in average, this group increased this variable), while the delta value was reduced in S-group. The same behavior was observed with the AII values. From regression models, only the AII explained positively and significantly the final value of VitD.


We did not find significant effect of synbiotic supplementation on VitD status in community-dwelling elderly; the biomarkers of systemic inflammation explained the final values of VitD. Several uncertainties were observed in our study, especially regarding the ideal marker of gut permeability and the ideal measure of VitD. More studies are needed before drawing definitive conclusions.

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Fig. 1



body fat percentage


anti-inflammatory index


Coordination for the Improvement of Higher Education Personnel


colony forming unit


dual-energy X-ray absorptiometry


São Paulo Research Foundation


body fat mass




high-performance liquid chromatography


intestinal fatty-acid binding protein








nuclear factor


group- placebo group


Brazilian Registration of Clinical Studies


synbiotic group


systematic review


vitamin D receptor


Vitamin D (25OH)D3

VitDfin :

final values of VitD

VitDin :

initial values of VitD


delta-value (difference between final and baseline results)


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The supplements used in this experiment were donated by Invictus-Farmanutrição® exclusively for research purposes. We thank to Nicola A.C. Zorzetto, for the English review. The authors acknowledge the help of the students João Valentini Neto and Angelica M. de Pina Freitas in data collection.


The authors thank the Coordination for the Improvement of Higher Education Personnel (CAPES) - (Protocol no. 06/2011-Casadinho-PROCAD), and São Paulo Research Foundation (FAPESP) – Research Project no. 2012/15976-0.

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Corresponding author

Correspondence to Sandra Maria Lima Ribeiro.

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Ethical standards

This study been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments; in addition, the study was approved by the Local Ethics in Human Research Committee (Process 200.870/2013). The procedures and the aim of the study were explained to the participants. While all the subjects were informed of the importance of remaining in the study for the entire 6 months, they were reassured of their right to withdraw from the study at any time. After the explanations, all the volunteers gave their informed consent prior to their inclusion in the study.

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de Carvalho, C.M.R.G., Luzia, L.A., Rondó, P.H. et al. Associations between vitamin D, systemic inflammation and synbiotic supplementation: secondary study from a randomized clinical trial. Nutrire 45, 4 (2020).

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  • Vitamin D
  • Systemic inflammation
  • Aging
  • Synbiotic
  • Randomized double-blind clinical study