OBJECTIVE: The aim of this study was to determine the effects of synbiotic food consumption on glycemic status and serum high sensitivity C-reactive protein (hs-CRP) levels of Iranian pregnant women. DESIGN: This randomized placebo-controlled clinical trial was performed among 52 pregnant women, primigravida, aged 18–35 year old, in their third trimester. After a 2-wk run-in period, subjects were randomly assigned to consume either a synbiotic (n=26) or control food (n=26) for 9 weeks. The synbiotic food consisted of a probiotic Lactobacillus sporogenes (1×107 CFU), 0.04 g inulin as prebiotic with 0.38 g isomalt, 0.36 g sorbitol and 0.05 g stevia as sweetener per 1 g. Control food (the same substance without probiotic bacteria and inulin) was packed in identical 9-gram packages. Patients were asked to consume the synbiotic and control foods two times a day. Fasting blood samples were taken at baseline and after a 9-wk intervention for quantification of related factors. RESULTS: Consumption of a synbiotic food did not show any significant change regarding the impact of insulin actions in the synbiotic group; nonetheless, compared to the control food, it resulted in a significant decrease in serum insulin levels (−0.26 vs. 6.34 µIU/mL, P=0.014) and HOMA-IR (−0.13 vs. 1.13, P=0.033), a significant difference in HOMA-B (5.30 vs. 34.22, P=0.040) and a significant rise in QUICKI score (0.002 vs. −0.02, P=0.022). CONCLUSIONS: Consumption of a synbiotic food for 9 weeks by pregnant women had beneficial effects on insulin actions compared to the control food, but did not affect FPG and serum hs-CRP concentrations.
Ensling M, Steinmann W, Whaley-Connell A, 2011 Hypoglycemia: A Possible Link between Insulin Resistance, Metabolic Dyslipidemia, and Heart and Kidney Disease (the Cardiorenal Syndrome). Cardiorenal Med 1: 67–74.
Johnson CA, 2008 Glucose homeostasis during canine pregnancy: Insulin resistance, ketosis, and hypoglycemia. Theriogenology 70: 1418–1423.
McLachlan KA, O’Neal D, Jenkins A, Alford FP, 2006 Do adiponectin, TNFalpha, leptin and CRP relate to insulin resistance in pregnancy? Studies in women with and without gestational diabetes, during and after pregnancy. Diabetes Metab Res Rev 22: 131–138.
Lu HL, Wang HW, Wen Y, Zhang MX, Lin HH, 2006 Roles of adipocyte derived hormone adiponectin and resistin in insulin resistance of type 2 diabetes. World J Gastroenterol 12: 1747–1751.
Senn JJ, Klover PJ, Nowak IA, Mooney RA, 2002 Interleukin-6 induces cellular insulin resistance in hepatocytes. Diabetes 51: 3391–3399.
Briana DD, Malamitsi-Puchner A, 2009 Reviews: adipocytokines in normal and complicated pregnancies. Reprod Sci 16: 921–937.
Clapp JF, 2006 Effects of Diet and Exercise on Insulin Resistance during Pregnancy. Metab Syndr Relat Disord 4: 84–90.
Pitiphat W, Gillman MW, Joshipura KJ, Williams PL, Douglass CW, Rich-Edwards JW, 2005 Plasma C-reactive protein in early pregnancy and preterm delivery. Am J Epidemiol 162: 1108–1113.
Stella CL, O’Brien JM, Forrester KJ, et al, 2008 The coexistence of gestational hypertension and diabetes: influence on pregnancy outcome. Am J Perinatol 25: 325–329.
Kayemba-Kay’s S, Peters C, Geary MP, Hill NR, Mathews DR, Hindmarsh PC, 2013 Maternal hyperinsulinism and glycaemic status in the first trimester of pregnancy are associated with the development of pregnancy-induced hypertension and gestational diabetes. Eur J Endocrinol 168: 413–418.
Karcaaltincaba D, Kandemir O, Yalvac S, Guvendag-Guven S, Haberal A, 2009 Prevalence of gestational diabetes mellitus and gestational impaired glucose tolerance in pregnant women evaluated by National Diabetes Data Group and Carpenter and Coustan criteria. Int J Gynaecol Obstet 106: 246–249.
Cheung NW, 2009 The management of gestational diabetes. Vasc Health Risk Manag 5: 153–164.
Seshiah V, Balaji V, Balaji MS, et al, 2007 Gestational diabetes mellitus manifests in all trimesters of pregnancy. Diabetes Res Clin Pract 77: 482–484.
Katon J, Maynard C, Reiber G, 2012 Attempts at weight loss in U.S. women with and without a history of gestational diabetes mellitus. Women’s Health Issues 22: e447–453.
Ferrara A, Hedderson MM, Albright CL, et al, 2011 A Pregnancy and Postpartum Lifestyle Intervention in Women With Gestational Diabetes Mellitus Reduces Diabetes Risk Factors: A feasibility randomized control trial. Diabetes Care 34: 1519–1525.
Prater MR, Laudermilch CL, Holladay SD, 2007 Does immune stimulation or antioxidant therapy reduce MNU-induced placental damage via activation of Jak-STAT and NFkappaB signaling pathways? Placenta 28: 566–570.
Lawrence JM, Andrade SE, Avalos LA, et al, 2013 Prevalence, trends, and patterns of use of antidiabetic medications among pregnant women, 2001–2007. Obstet Gynecol 121: 106–114.
Borzychowski AM, Sargent IL, Redman CW, 2006 Inflammation and pre-eclampsia. Semin Fetal Neonatal Med 11: 309–316.
Asemi Z, Samimi M, Tabassi Z, et al, 2013 Effect of daily consumption of probiotic yoghurt on insulin resistance in pregnant women: a randomized controlled trial. Eur J Clin Nutr 67: 71–74.
Asemi Z, Jazayeri S, Najafi M, et al, 2011 Effects of daily consumption of probiotic yoghurt on inflammatory factors in pregnant women: a randomized controlled trial. Pak J Biol Sci 14: 476–482.
Asemi Z, Khorrami-Rad A, Alizadeh SA, Shakeri H, Esmaillzadeh A, 2013 Effects of synbiotic food consumption on metabolic status of diabetic patients: a double-blind randomized cross-over controlled clinical trial. Clin Nutr 33: 198–203.
D’Souza A, Fordjour U, Ahmad A, et al, 2010 Effects of probiotics, prebiotics, and synbiotics on messenger RNA expression of caveolin-1, NOS, and genes regulating oxidative stress in the terminal ileum of formula-fed neonatal rats. Pediatr Res 67: 526–531.
Neto JV, de Melo CM, Ribeiro SM, 2013 Effects of three-month intake of synbiotic on inflammation and body composition in the elderly: a pilot study. Nutrients 5: 1276–1286.
Vitali B, Ndagijimana M, Cruciani F, et al, 2010 Impact of a synbiotic food on the gut microbial ecology and metabolic profiles. BMC Microbiol 10: 4.
Yadav H, Lee JH, Lloyd J, Walter P, Rane SG, 2013 Beneficial metabolic effects of a probiotic via butyrate induced GLP-1 secretion. J Biol Chem 288: 25088–25097.
Voltolini C, Battersby S, Etherington SL, Petraglia F, Norman JE, Jabbour HN, 2012 A novel antiinflammatory role for the short-chain fatty acids in human labor. Endocrinology 153: 395–403.
Jehan I, Zaidi S, Rizvi S, et al, 2010 Dating gestational age by last menstrual period, symphysis-fundal height, and ultrasound in urban Pakistan. Int J Gynaecol Obstet 110: 231–234.
Pisprasert V, Ingram KH, Lopez-Davila MF, Munoz AJ, Garvey WT, 2013 Limitations in the use of indices using glucose and insulin levels to predict insulin sensitivity: impact of race and gender and superiority of the indices derived from oral glucose tolerance test in African Americans. Diabetes Care 36: 845–853.
Vitali B, Ndagijimana M, Maccaferri S, Biagi E, Guerzoni ME, Brigidi P, 2012 An in vitro evaluation of the effect of probiotics and prebiotics on the metabolic profile of human microbiota. Anaerobe 18: 386–391.
Giamarellos-Bourboulis EJ, Bengmark S, Kanellakopoulou K, Kotzampassi K, 2009 Pro- and synbiotics to control inflammation and infection in patients with multiple injuries. J Trauma 67: 815–821.
Andreasen AS, Larsen N, Pedersen-Skovsgaard T, et al, 2010 Effects of Lactobacillus acidophilus NCFM on insulin sensitivity and the systemic inflammatory response in human subjects. Br J Nutr 104: 1831–1838.
Tabuchi M, Ozaki M, Tamura A, et al, 2003 Antidiabetic effect of Lactobacillus GG in streptozotocin-induced diabetic rats. Biosci Biotechnol Biochem 67: 1421–1424.
Cani PD, Neyrinck AM, Fava F, et al, 2007 Selective increases of bifidobacteria in gut microflora improve high-fat-diet-induced diabetes in mice through a mechanism associated with endotoxaemia. Diabetologia 50: 2374–2383.
Musso G, Gambino R, Cassader M, 2010 Obesity, diabetes, and gut microbiota: the hygiene hypothesis expanded? Diabetes Care 33: 2277–2284.
Kondo S, Xiao JZ, Satoh T, et al, 2010 Antiobesity effects of Bifidobacterium breve strain B-3 supplementation in a mouse model with high-fat diet-induced obesity. Biosci Biotechnol Biochem 74: 1656–1661.
Hsieh FC, Lee CL, Chai CY, Chen WT, Lu YC, Wu CS, 2013 Oral administration of Lactobacillus reuteri GMNL-263 improves insulin resistance and ameliorates hepatic steatosis in high fructose-fed rats. Nutr Metab (Lond) 10: 35.
Li Z, Yang S, Lin H, et al, 2003 Probiotics and antibodies to TNF inhibit inflammatory activity and improve nonalcoholic fatty liver disease. Hepatology 37: 343–350.
Naito E, Yoshida Y, Makino K, et al, 2011 Beneficial effect of oral administration of Lactobacillus casei strain Shirota on insulin resistance in diet-induced obesity mice. J Appl Microbiol 110: 650–657.
Asemi Z, Zare Z, Shakeri H, Sabihi S-S, Esmaillzadeh A, 2013 Effect of multispecies probiotic supplements on metabolic profile, hs-CRP and oxidative stress in patients with type 2 diabetes. Ann Nutr Metab 63: 1–9.
Esteve E, Ricart W, Fernandez-Real JM, 2011 Gut microbiota interactions with obesity, insulin resistance and type 2 diabetes: did gut microbiote co-evolve with insulin resistance? Curr Opin Clin Nutr Metab Care 14: 483–490.
Diamant M, Blaak EE, de Vos WM, 2011 Do nutrientgut-microbiota interactions play a role in human obesity, insulin resistance and type 2 diabetes? Obes Rev Obes Rev: 272–281.
Caricilli AM, Picardi PK, de Abreu LL, et al, 2011 Gut microbiota is a key modulator of insulin resistance in TLR 2 knockout mice. PLoS Biol 9: e1001212.
Cani PD, Possemiers S, Van de Wiele T, et al, 2009 Changes in gut microbiota control inflammation in obese mice through a mechanism involving GLP-2-driven improvement of gut permeability. Gut 58: 1091–1103.
Mazloom Z, Yousefinejad A, Dabbaghmanesh MH, 2013 Effect of probiotics on lipid profile, glycemic control, insulin action, oxidative stress, and inflammatory markers in patients with type 2 diabetes: a clinical trial. Iran J Med Sci 38: 38–43.
Hatakka K, Martio J, Korpela M, et al, 2003 Effects of probiotic therapy on the activity and activation of mild rheumatoid arthritis—a pilot study. Scand J Rheumatol 32: 211–215.
McNaught CE, Woodcock NP, Anderson AD, MacFie J, 2005 A prospective randomised trial of probiotics in critically ill patients. Clin Nutr 24: 211–219.
Sugawara G, Nagino M, Nishio H, et al, 2006 Perioperative synbiotic treatment to prevent postoperative infectious complications in biliary cancer surgery: a randomized controlled trial. Ann Surg 244: 706–714.
Usami M, Miyoshi M, Kanbara Y, et al, 2011 Effects of perioperative synbiotic treatment on infectious complications, intestinal integrity, and fecal flora and organic acids in hepatic surgery with or without cirrhosis. JPEN J Parenter Enteral Nutr 35: 317–328.
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Taghizadeh, M., Asemi, Z. Effects of synbiotic food consumption on glycemic status and serum hs-CRP in pregnant women: a randomized controlled clinical trial. Hormones 13, 398–406 (2014). https://doi.org/10.14310/horm.2002.1489
- Glycemic status
- High sensitivity C-reactive protein
- Pregnant women