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Randomized Controlled Trial
. 2022 Jan-Dec;14(1):2003176.
doi: 10.1080/19490976.2021.2003176.

Combined berberine and probiotic treatment as an effective regimen for improving postprandial hyperlipidemia in type 2 diabetes patients: a double blinded placebo controlled randomized study

Shujie Wang  1   2 , Huahui Ren  3   4 , Huanzi Zhong  3 , Xinjie Zhao  5 , Changkun Li  1   2   6 , Jing Ma  6 , Xuejiang Gu  7 , Yaoming Xue  8 , Shan Huang  9 , Jialin Yang  10 , Li Chen  11 , Gang Chen  12 , Shen Qu  13 , Jun Liang  14 , Li Qin  15 , Qin Huang  16 , Yongde Peng  17 , Qi Li  5 , Xiaolin Wang  5 , Yuanqiang Zou  3 , Zhun Shi  3 , Xuelin Li  1   2 , Tingting Li  1   2 , Huanming Yang  3   18 , Shenghan Lai  19 , Guowang Xu  5 , Junhua Li  3 , Yifei Zhang  1   2 , Yanyun Gu  1   2 , Weiqing Wang  1   2
Affiliations
Randomized Controlled Trial

Combined berberine and probiotic treatment as an effective regimen for improving postprandial hyperlipidemia in type 2 diabetes patients: a double blinded placebo controlled randomized study

Shujie Wang et al. Gut Microbes. 2022 Jan-Dec.

Abstract

Non-fasting lipidemia (nFL), mainly contributed by postprandial lipidemia (PL), has recently been recognized as an important cardiovascular disease (CVD) risk as fasting lipidemia (FL). PL serves as a common feature of dyslipidemia in Type 2 Diabetes (T2D), albeit effective therapies targeting on PL were limited. In this study, we aimed to evaluate whether the therapy combining probiotics (Prob) and berberine (BBR), a proven antidiabetic and hypolipidemic regimen via altering gut microbiome, could effectively reduce PL in T2D and to explore the underlying mechanism. Blood PL (120 min after taking 100 g standard carbohydrate meal) was examined in 365 participants with T2D from the Probiotics and BBR on the Efficacy and Change of Gut Microbiota in Patients with Newly Diagnosed Type 2 Diabetes (PREMOTE study), a random, placebo-controlled, and multicenter clinical trial. Prob+BBR was superior to BBR or Prob alone in improving postprandial total cholesterol (pTC) and low-density lipoprotein cholesterol (pLDLc) levels with decrement of multiple species of postprandial lipidomic metabolites after 3 months follow-up. This effect was linked to the changes of fecal Bifidobacterium breve level responding to BBR alone or Prob+BBR treatment. Four fadD genes encoding long-chain acyl-CoA synthetase were identified in the genome of this B. breve strain, and transcriptionally activated by BBR. In vitro BBR treatment further decreased the concentration of FFA in the culture medium of B. breve compared to vehicle. Thus, the activation of fadD by BBR could enhance FFA import and mobilization in B. breve and diliminish the intraluminal lipids for absorption to mediate the effect of Prob+BBR on PL. Our study confirmed that BBR and Prob (B. breve) could exert a synergistic hypolipidemic effect on PL, acting as a gut lipid sink to achieve better lipidemia and CVD risk control in T2D.

Keywords: Type 2 diabetes; berberine; dyslipidemia; gut microbiome; postprandial lipidemia; probiotics.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Lipidomic study on postprandial blood samples
Figure 2.
Figure 2.
Gut microbial species correlate with blood lipidemia profiles
Figure 3.
Figure 3.
B. breve correlates with lipid metabolites changes and is depleted by BBR
Figure 4.
Figure 4.
BBR activates lipid metabolism in B. breve.
See this image and copyright information in PMC

References

    1. Goff DC Jr., Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S49–19. doi:10.1161/01.cir.0000437741.48606.98. - DOI - PubMed
    1. Emerging Risk Factors C, Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375(9733):2215–2222. doi:10.1016/S0140-6736(10)60484-9. - DOI - PMC - PubMed
    1. Low Wang CC, Hess CN, Hiatt WR, Goldfine AB.. Clinical Update: cardiovascular Disease in Diabetes Mellitus: atherosclerotic Cardiovascular Disease and Heart Failure in Type 2 Diabetes Mellitus - Mechanisms, Management, and Clinical Considerations. Circulation. 2016;133(24):2459–2502. doi:10.1161/CIRCULATIONAHA.116.022194. - DOI - PMC - PubMed
    1. Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr., Tleyjeh IM, Rybak MJ, et al. Infective Endocarditis in Adults: diagnosis, Antimicrobial Therapy, and Management of Complications: a Scientific Statement for Healthcare Professionals From the American Heart Association. Circulation. 2015;132(15):1435–1486. doi:10.1161/CIR.0000000000000296. - DOI - PubMed
    1. Nordestgaard BG, Benn M, Schnohr P, Tybjaerg-Hansen A. Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA. 2007;298(3):299–308. doi:10.1001/jama.298.3.299. - DOI - PubMed

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