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Erschienen in: Obesity Surgery 5/2021

14.01.2021 | Original Contributions

Effects of Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 Supplementation on Nutritional and Metabolic Parameters in the Early Postoperative Period after Roux-en-Y Gastric Bypass: a Randomized, Double-Blind, Placebo-Controlled Trial

Erschienen in: Obesity Surgery | Ausgabe 5/2021

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Abstract

Studies have suggested that Roux-en-Y gastric bypass (RYGB) causes changes in the intestinal microbiota composition and function due to anatomical and physiological modifications. The role of probiotic supplementation after bariatric procedures remains to be determined.

Purpose

The aim of this study was to investigate the effects of Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 supplementation on nutritional and metabolic parameters after RYGB.

Materials and Methods

This is a randomized, double-blind, placebo-controlled clinical trial. Patients were assigned to receive either a probiotic supplement (FloraVantage®) or placebo for three consecutive months, beginning 7 days after surgery. Anthropometric and biochemical indexes were evaluated in the preoperative period and at the end of the study.

Results

Following RYGB, serum 25-OH vitamin D increased in both groups compared to baseline; however, this increase was significant only in the probiotic group (p = 0.004). Vitamin B12 levels tended to be higher in the probiotic group compared to the placebo group (p = 0.063), and triglyceride levels showed a significant reduction in the probiotic group only (p < 0.001). In addition, a significant reduction was observed in the anthropometric parameters and glycemic profile (p < 0.05) in both groups.

Conclusion

Probiotic supplementation after RYGB improves the vitamin and lipid profile.
Literatur
1.
Zurück zum Zitat Gonzalez AB De, Phil D, Hartge P, Sc D, Cerhan JR, Ph D, et al. NIH Public Access. 2011;363:2211–9. Gonzalez AB De, Phil D, Hartge P, Sc D, Cerhan JR, Ph D, et al. NIH Public Access. 2011;363:2211–9.
2.
Zurück zum Zitat Lee WJ, Almulaifi A. Recent advances in bariatric/metabolic surgery: appraisal of clinical evidence. J Biomed Res. 2015;29:98–104.PubMed Lee WJ, Almulaifi A. Recent advances in bariatric/metabolic surgery: appraisal of clinical evidence. J Biomed Res. 2015;29:98–104.PubMed
3.
Zurück zum Zitat Tsatsoulis A, Paschou SA. Metabolically healthy obesity: criteria, epidemiology, controversies, and consequences. Curr Obes Rep. 2020;9:109–20.CrossRef Tsatsoulis A, Paschou SA. Metabolically healthy obesity: criteria, epidemiology, controversies, and consequences. Curr Obes Rep. 2020;9:109–20.CrossRef
4.
Zurück zum Zitat Hruby A, Hu FB. The epidemiology of obesity: a big picture. Pharmacoeconomics. 2015;33:673–89.CrossRef Hruby A, Hu FB. The epidemiology of obesity: a big picture. Pharmacoeconomics. 2015;33:673–89.CrossRef
5.
Zurück zum Zitat Mazloom K, Siddiqi I, Covasa M. Probiotics: how effective are they in the fight against obesity? Nutrients. 2019;11:1–24.CrossRef Mazloom K, Siddiqi I, Covasa M. Probiotics: how effective are they in the fight against obesity? Nutrients. 2019;11:1–24.CrossRef
9.
Zurück zum Zitat Bernardeau M, Vernoux JP, Henri-Dubernet S, et al. Safety assessment of dairy microorganisms: the Lactobacillus genus. Int J Food Microbiol. 2008;126:278–85.CrossRef Bernardeau M, Vernoux JP, Henri-Dubernet S, et al. Safety assessment of dairy microorganisms: the Lactobacillus genus. Int J Food Microbiol. 2008;126:278–85.CrossRef
10.
Zurück zum Zitat Russell DA, Ross RP, Fitzgerald GF, et al. Metabolic activities and probiotic potential of bifidobacteria. Int J Food Microbiol. 2011;149:88–105.CrossRef Russell DA, Ross RP, Fitzgerald GF, et al. Metabolic activities and probiotic potential of bifidobacteria. Int J Food Microbiol. 2011;149:88–105.CrossRef
11.
Zurück zum Zitat Falcinelli S, Rodiles A, Hatef A, et al. Influence of probiotics administration on gut microbiota core a review on the effects on appetite control, glucose, and lipid metabolism. J Clin Gastroenterol. 2018;52:S50–6.CrossRef Falcinelli S, Rodiles A, Hatef A, et al. Influence of probiotics administration on gut microbiota core a review on the effects on appetite control, glucose, and lipid metabolism. J Clin Gastroenterol. 2018;52:S50–6.CrossRef
13.
Zurück zum Zitat Kumar M, Nagpal R, Kumar R, et al. Cholesterol-lowering probiotics as potential biotherapeutics for metabolic diseases. Exp Diabetes Res. 2012;2012:1–14.CrossRef Kumar M, Nagpal R, Kumar R, et al. Cholesterol-lowering probiotics as potential biotherapeutics for metabolic diseases. Exp Diabetes Res. 2012;2012:1–14.CrossRef
14.
Zurück zum Zitat Leblanc JG, Laiño JE, del Valle MJ, et al. B-group vitamin production by lactic acid bacteria - current knowledge and potential applications. J Appl Microbiol. 2011;111:1297–309.CrossRef Leblanc JG, Laiño JE, del Valle MJ, et al. B-group vitamin production by lactic acid bacteria - current knowledge and potential applications. J Appl Microbiol. 2011;111:1297–309.CrossRef
15.
Zurück zum Zitat Lee ES, Song EJ, Do NY, et al. Probiotics in human health and disease: from nutribiotics to pharmabiotics. J Microbiol. 2018;56:773–82.CrossRef Lee ES, Song EJ, Do NY, et al. Probiotics in human health and disease: from nutribiotics to pharmabiotics. J Microbiol. 2018;56:773–82.CrossRef
16.
Zurück zum Zitat Fernandes R, Beserra BTS, Mocellin MC, et al. Effects of prebiotic and synbiotic supplementation on inflammatory markers and anthropometric indices after Roux-en-Y gastric bypass. J Clin Gastroenterol. 2016;50:208–17.CrossRef Fernandes R, Beserra BTS, Mocellin MC, et al. Effects of prebiotic and synbiotic supplementation on inflammatory markers and anthropometric indices after Roux-en-Y gastric bypass. J Clin Gastroenterol. 2016;50:208–17.CrossRef
17.
Zurück zum Zitat Woodard GA, Encarnacion B, Downey JR, et al. Probiotics improve outcomes after roux-en-Y gastric bypass surgery: a prospective randomized trial. J Gastrointest Surg. 2009;13:1198–204.CrossRef Woodard GA, Encarnacion B, Downey JR, et al. Probiotics improve outcomes after roux-en-Y gastric bypass surgery: a prospective randomized trial. J Gastrointest Surg. 2009;13:1198–204.CrossRef
18.
Zurück zum Zitat Wagner NRF, Ramos MRZ, de Oliveira Carlos L, da Cruz MRR, Taconeli CA, Filho AJB, et al. Effects of probiotics supplementation on gastrointestinal symptoms and SIBO after Roux-en-Y gastric bypass: a prospective, randomized, double-blind, placebo-controlled trial. Obes Surg. 2020. Wagner NRF, Ramos MRZ, de Oliveira Carlos L, da Cruz MRR, Taconeli CA, Filho AJB, et al. Effects of probiotics supplementation on gastrointestinal symptoms and SIBO after Roux-en-Y gastric bypass: a prospective, randomized, double-blind, placebo-controlled trial. Obes Surg. 2020.
19.
Zurück zum Zitat Karbaschian Z, Mokhtari Z, Pazouki A, et al. Probiotic supplementation in morbid obese patients undergoing one anastomosis gastric bypass-mini gastric bypass (OAGB-MGB) surgery: a randomized, double-blind, placebo-controlled, Clinical Trial. Obes Surg. 2018;28:2874–85.CrossRef Karbaschian Z, Mokhtari Z, Pazouki A, et al. Probiotic supplementation in morbid obese patients undergoing one anastomosis gastric bypass-mini gastric bypass (OAGB-MGB) surgery: a randomized, double-blind, placebo-controlled, Clinical Trial. Obes Surg. 2018;28:2874–85.CrossRef
20.
Zurück zum Zitat Mokhtari Z, Karbaschian Z, Pazouki A, et al. The effects of probiotic supplements on blood markers of endotoxin and lipid peroxidation in patients undergoing gastric bypass surgery; a randomized, double-blind, placebo-controlled, clinical trial with 13 months follow-up. Obes Surg. 2019;29:1248–58.CrossRef Mokhtari Z, Karbaschian Z, Pazouki A, et al. The effects of probiotic supplements on blood markers of endotoxin and lipid peroxidation in patients undergoing gastric bypass surgery; a randomized, double-blind, placebo-controlled, clinical trial with 13 months follow-up. Obes Surg. 2019;29:1248–58.CrossRef
21.
Zurück zum Zitat Deitel M, Gawdat K, Melissas J. Reporting weight loss. Obes Surg. 2007;17:1275.CrossRef Deitel M, Gawdat K, Melissas J. Reporting weight loss. Obes Surg. 2007;17:1275.CrossRef
23.
Zurück zum Zitat Katz A, Nambi SS, Mather K, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000;85:2402–10.CrossRef Katz A, Nambi SS, Mather K, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000;85:2402–10.CrossRef
24.
Zurück zum Zitat Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.CrossRef Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.CrossRef
27.
Zurück zum Zitat Halekoh U, Højsgaard S, Yan J. The R package geepack for generalized estimating equations. J Stat Softw. 2006;15:1–11.CrossRef Halekoh U, Højsgaard S, Yan J. The R package geepack for generalized estimating equations. J Stat Softw. 2006;15:1–11.CrossRef
28.
Zurück zum Zitat Yan J, Fine J. Estimating equations for association structures. Stat Med. 2004;23:859–74.CrossRef Yan J, Fine J. Estimating equations for association structures. Stat Med. 2004;23:859–74.CrossRef
31.
Zurück zum Zitat Adams TD, Davidson LE, Litwin SE, et al. Weight and metabolic outcomes 12 years after gastric bypass. N Engl J Med. 2017;377:1143–55.CrossRef Adams TD, Davidson LE, Litwin SE, et al. Weight and metabolic outcomes 12 years after gastric bypass. N Engl J Med. 2017;377:1143–55.CrossRef
32.
Zurück zum Zitat Halperin F, Ding SA, Simonson DC, et al. Roux-en-Y gastric bypass surgery or lifestyle with intensive medical management in patients with type 2 diabetes: feasibility and 1-year results of a randomized clinical trial. JAMA Surg. 2014;149:716–26.CrossRef Halperin F, Ding SA, Simonson DC, et al. Roux-en-Y gastric bypass surgery or lifestyle with intensive medical management in patients with type 2 diabetes: feasibility and 1-year results of a randomized clinical trial. JAMA Surg. 2014;149:716–26.CrossRef
33.
Zurück zum Zitat Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes - 5-year outcomes. N Engl J Med. 2017;376:641–51.CrossRef Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes - 5-year outcomes. N Engl J Med. 2017;376:641–51.CrossRef
34.
Zurück zum Zitat Adams TD, Pendleton RC, Strong MB, et al. Health outcomes of gastric bypass patients compared to nonsurgical, nonintervened severely obese. Obesity. 2010;18:121–30.CrossRef Adams TD, Pendleton RC, Strong MB, et al. Health outcomes of gastric bypass patients compared to nonsurgical, nonintervened severely obese. Obesity. 2010;18:121–30.CrossRef
35.
Zurück zum Zitat Cummings DE, Overduin J, Foster-Schubert KE. Gastric bypass for obesity: mechanisms of weight loss and diabetes resolution. J Clin Endocrinol Metab. 2004;89:2608–15.CrossRef Cummings DE, Overduin J, Foster-Schubert KE. Gastric bypass for obesity: mechanisms of weight loss and diabetes resolution. J Clin Endocrinol Metab. 2004;89:2608–15.CrossRef
36.
Zurück zum Zitat Ionut V, Bergman RN. Mechanisms responsible for excess weight loss after bariatric surgery. J Diabetes Sci Technol. 2011;5:1263–82.CrossRef Ionut V, Bergman RN. Mechanisms responsible for excess weight loss after bariatric surgery. J Diabetes Sci Technol. 2011;5:1263–82.CrossRef
37.
Zurück zum Zitat Ulker I, Yildiran H. The effects of bariatric surgery on gut microbiota in patients with obesity: a review of the literature. Biosci Microbiota Food Health. 2019;38:3–9.CrossRef Ulker I, Yildiran H. The effects of bariatric surgery on gut microbiota in patients with obesity: a review of the literature. Biosci Microbiota Food Health. 2019;38:3–9.CrossRef
38.
39.
Zurück zum Zitat Rouxinol-Dias AL, Pinto AR, Janeiro C, Rodrigues D, Moreira M, Dias J, et al. Probiotics for the control of obesity - its effect on weight change. Porto Biomed J. PBJ-Associação Porto Biomedical/Porto Biomedical Society; 2016;1:12–24. Available from: https://doi.org/10.1016/j.pbj.2016.03.005. Rouxinol-Dias AL, Pinto AR, Janeiro C, Rodrigues D, Moreira M, Dias J, et al. Probiotics for the control of obesity - its effect on weight change. Porto Biomed J. PBJ-Associação Porto Biomedical/Porto Biomedical Society; 2016;1:12–24. Available from: https://​doi.​org/​10.​1016/​j.​pbj.​2016.​03.​005.
40.
Zurück zum Zitat Ciobârcă DCAF, Copăescu C, Miere DCG. Bariatric surgery in obesity : effects on gut microbiota and micronutrient status. Nutrients. 2020;12:235.CrossRef Ciobârcă DCAF, Copăescu C, Miere DCG. Bariatric surgery in obesity : effects on gut microbiota and micronutrient status. Nutrients. 2020;12:235.CrossRef
41.
Zurück zum Zitat Patel JJ, Mundi MS, Hurt RT, et al. Micronutrient deficiencies after bariatric surgery: an emphasis on vitamins and trace minerals. Nutr Clin Pract. 2017;32:471–80.CrossRef Patel JJ, Mundi MS, Hurt RT, et al. Micronutrient deficiencies after bariatric surgery: an emphasis on vitamins and trace minerals. Nutr Clin Pract. 2017;32:471–80.CrossRef
43.
Zurück zum Zitat Mason C, Xiao L, Imayama I, et al. Effects of weight loss on serum vitamin D in postmenopausal women. Am J Clin Nutr. 2011;94:95–103.CrossRef Mason C, Xiao L, Imayama I, et al. Effects of weight loss on serum vitamin D in postmenopausal women. Am J Clin Nutr. 2011;94:95–103.CrossRef
44.
Zurück zum Zitat Shang M, Sun J. Vitamin D/VDR, probiotics, and gastrointestinal diseases. Curr Med Chem. 2016;24:876–87.CrossRef Shang M, Sun J. Vitamin D/VDR, probiotics, and gastrointestinal diseases. Curr Med Chem. 2016;24:876–87.CrossRef
45.
Zurück zum Zitat Jones ML, Martoni CJ, Prakash S. Oral supplementation with probiotic L. reuteri NCIMB 30242 increases mean circulating 25-hydroxyvitamin D: a post hoc analysis of a randomized controlled trial. J Clin Endocrinol Metab. 2013;98:2944–51.CrossRef Jones ML, Martoni CJ, Prakash S. Oral supplementation with probiotic L. reuteri NCIMB 30242 increases mean circulating 25-hydroxyvitamin D: a post hoc analysis of a randomized controlled trial. J Clin Endocrinol Metab. 2013;98:2944–51.CrossRef
47.
Zurück zum Zitat Fuentes MC, Lajo T, Carrión JM, et al. Cholesterol-lowering efficacy of Lactobacillus plantarum CECT 7527, 7528 and 7529 in hypercholesterolaemic adults. Br J Nutr. 2013;109:1866–72.CrossRef Fuentes MC, Lajo T, Carrión JM, et al. Cholesterol-lowering efficacy of Lactobacillus plantarum CECT 7527, 7528 and 7529 in hypercholesterolaemic adults. Br J Nutr. 2013;109:1866–72.CrossRef
48.
Zurück zum Zitat Choi ID, Kim SH, Jeong JW, et al. Triglyceride-lowering effects of two probiotics, Lactobacillus plantarum KY1032 and Lactobacillus curvatus HY7601, in a rat model of high-fat diet-induced hypertriglyceridemia. J Microbiol Biotechnol. 2015;26:483–7.CrossRef Choi ID, Kim SH, Jeong JW, et al. Triglyceride-lowering effects of two probiotics, Lactobacillus plantarum KY1032 and Lactobacillus curvatus HY7601, in a rat model of high-fat diet-induced hypertriglyceridemia. J Microbiol Biotechnol. 2015;26:483–7.CrossRef
49.
Zurück zum Zitat Tonucci LB, Olbrich dos Santos KM, Licursi de Oliveira L, Rocha Ribeiro SM, Duarte Martino HS. Clinical application of probiotics in type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled study. Clin Nutr. Elsevier Ltd; 2017;36:85–92. Available from: https://doi.org/10.1016/j.clnu.2015.11.011. Tonucci LB, Olbrich dos Santos KM, Licursi de Oliveira L, Rocha Ribeiro SM, Duarte Martino HS. Clinical application of probiotics in type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled study. Clin Nutr. Elsevier Ltd; 2017;36:85–92. Available from: https://​doi.​org/​10.​1016/​j.​clnu.​2015.​11.​011.
50.
Zurück zum Zitat Pourrajab B, Fatahi S, Dehnad A, Kord Varkaneh H, Shidfar F. The impact of probiotic yogurt consumption on lipid profiles in subjects with mild to moderate hypercholesterolemia: a systematic review and meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. The societies SID, SISA and SINU and the Department of Clinical Medicine and Surgery at Federico II University in Italy; 2020;30:11–22. Available from: https://doi.org/10.1016/j.numecd.2019.10.001 Pourrajab B, Fatahi S, Dehnad A, Kord Varkaneh H, Shidfar F. The impact of probiotic yogurt consumption on lipid profiles in subjects with mild to moderate hypercholesterolemia: a systematic review and meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. The societies SID, SISA and SINU and the Department of Clinical Medicine and Surgery at Federico II University in Italy; 2020;30:11–22. Available from: https://​doi.​org/​10.​1016/​j.​numecd.​2019.​10.​001
51.
Zurück zum Zitat Jiang J, Wu C, Zhang C, Zhao J, Yu L, Zhang H, et al. Effects of probiotic supplementation on cardiovascular risk factors in hypercholesterolemia: a systematic review and meta-analysis of randomized clinical trial. J Funct Foods. Elsevier; 2020;74:104177. Available from: https://doi.org/10.1016/j.jff.2020.104177 Jiang J, Wu C, Zhang C, Zhao J, Yu L, Zhang H, et al. Effects of probiotic supplementation on cardiovascular risk factors in hypercholesterolemia: a systematic review and meta-analysis of randomized clinical trial. J Funct Foods. Elsevier; 2020;74:104177. Available from: https://​doi.​org/​10.​1016/​j.​jff.​2020.​104177
52.
Zurück zum Zitat Klaver FAM, Van der Meer R. The assumed assimilation of cholesterol by lactobacilli and Bifidobacterium bifidum is due to their bile salt-deconjugating activity. Appl Environ Microbiol. 1993;59:1120–4.CrossRef Klaver FAM, Van der Meer R. The assumed assimilation of cholesterol by lactobacilli and Bifidobacterium bifidum is due to their bile salt-deconjugating activity. Appl Environ Microbiol. 1993;59:1120–4.CrossRef
53.
Zurück zum Zitat Xie N, Cui Y, Yin YN, Zhao X, Yang JW, Wang ZG, et al. Effects of two Lactobacillus strains on lipid metabolism and intestinal microflora in rats fed a high-cholesterol diet. BMC Complement Altern Med. BioMed Central Ltd; 2011;11:53. Available from: http://www.biomedcentral.com/1472-6882/11/53. Xie N, Cui Y, Yin YN, Zhao X, Yang JW, Wang ZG, et al. Effects of two Lactobacillus strains on lipid metabolism and intestinal microflora in rats fed a high-cholesterol diet. BMC Complement Altern Med. BioMed Central Ltd; 2011;11:53. Available from: http://​www.​biomedcentral.​com/​1472-6882/​11/​53.
54.
Zurück zum Zitat Kimoto H, Ohmomo S, Okamoto T. Cholesterol removal from media by lactococci. J Dairy Sci. Elsevier; 2002;85:3182–8. Kimoto H, Ohmomo S, Okamoto T. Cholesterol removal from media by lactococci. J Dairy Sci. Elsevier; 2002;85:3182–8.
55.
Zurück zum Zitat Tomaro-Duchesneau C, Jones ML, Shah D, et al. Cholesterol assimilation by Lactobacillus probiotic bacteria: an in vitro investigation. Biomed Res Int. 2014;2014:1–9.CrossRef Tomaro-Duchesneau C, Jones ML, Shah D, et al. Cholesterol assimilation by Lactobacillus probiotic bacteria: an in vitro investigation. Biomed Res Int. 2014;2014:1–9.CrossRef
56.
Zurück zum Zitat Yao K, Zeng L, He Q, et al. Effect of probiotics on glucose and lipid metabolism in type 2 diabetes mellitus: a meta-analysis of 12 randomized controlled trials. Med Sci Monit. 2017;23:3044–30453.CrossRef Yao K, Zeng L, He Q, et al. Effect of probiotics on glucose and lipid metabolism in type 2 diabetes mellitus: a meta-analysis of 12 randomized controlled trials. Med Sci Monit. 2017;23:3044–30453.CrossRef
Metadaten
Titel
Effects of Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 Supplementation on Nutritional and Metabolic Parameters in the Early Postoperative Period after Roux-en-Y Gastric Bypass: a Randomized, Double-Blind, Placebo-Controlled Trial
Publikationsdatum
14.01.2021
Erschienen in
Obesity Surgery / Ausgabe 5/2021
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-021-05222-2

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