nach oben

Erschienen in:

05.05.2020 | Review

Therapy with probiotics and synbiotics for polycystic ovarian syndrome: a systematic review and meta-analysis

verfasst von: Mauro Cozzolino, Amerigo Vitagliano, Livia Pellegrini, Martina Chiurazzi, Alessandra Andriasani, Guido Ambrosini, Nicolas Garrido

Erschienen in: European Journal of Nutrition | Ausgabe 7/2020

Einloggen, um Zugang zu erhalten

Abstract

Objective

Several randomized controlled trials (RCTs) have investigated the use of probiotic/synbiotic in PCOS patients, without clarifying the real use in clinical practice. The aim of this meta-analysis was to evaluate the effectiveness of probiotics and synbiotics on metabolic, hormonal and inflammatory parameters of PCOS.

Methods

Electronic databases (MEDLINE, Scopus, EMBASE, ScienceDirect, The Cochrane Database of Systematic Reviews and ClinicalTrials.gov) were searched from their inception until May 2019. The study protocol was registered in PROSPERO with number CRD42018111534. Randomized controlled trials (RCTs) of PCOS’s women undergoing therapy at least 8 weeks with probiotics or synbiotics or without therapy were included. The primary outcomes were changes in anthropometric parameters, glucose/insulin metabolism, lipid profile, sex hormones profile, inflammation markers.

Results

587 patients were included in nine RCT. The administration of probiotic/synbiotic were associated with a significant improvement in FPG, FBI, HOMA I-R, BMI. It also modified Ferriman-Gallway, serum triglycerides, serum testosterone, hs-CRP, NO, TAC, GSH, and MDA. Subgroup analysis of the type of intervention showed that probiotics were associated with greater testosterone and FPG reduction; synbiotics administration resulted in a more pronounced decrease of the FBI. Subgroup analyses on the duration of therapy showed that, probiotic/synbiotic administration had a significantly greater effect on QUICK-I in the case of women with 12-weeks of therapy than in the 8-weeks therapy group. Nevertheless, we did not observe any significant difference was observed in terms of FBI, HOMA-IR, and FPG.

Conclusions

Probiotics and synbiotics seem to either an effect on/influence metabolic, hormonal and inflammatory parameters, or can influence them. Consequently, it could lead to an improvement of fertility in PCOS.

Nur mit Berechtigung zugänglich

Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2008) Consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod 23(3):462–477CrossRef

Duleba AJ, Dokras A (2012) Is PCOS an inflammatory process? Fertil Steril 97(1):7–12CrossRef

Farrell K, Antoni MH (2010) Insulin resistance, obesity, inflammation, and depression in polycystic ovary syndrome: biobehavioral mechanisms and interventions. Fertil Steril 94(5):1565–1574CrossRef

Clemente JC, Ursell LK, Parfrey LW, Knight R (2012) The impact of the gut microbiota on human health: an integrative view. Cell 148(6):1258–1270CrossRef

Gensollen T, Iyer SS, Kasper DL, Blumberg RS (2016) How colonization by microbiota in early life shapes the immune system. Science 352(6285):539–544CrossRef

Cani PD, Amar J, Iglesias MA, Poggi M, Knauf C, Bastelica D et al (2007) Metabolic endotoxemia initiates obesity and insulin resistance. Diabetes 56(7):1761–1772CrossRef

Kau AL, Ahern PP, Griffin NW, Goodman AL, Gordon JI (2011) Human nutrition, the gut microbiome and the immune system. Nature 474(7351):327–336CrossRef

Maranduba CM, De Castro SB, de Souza GT, Rossato C, da Guia FC, Valente MA et al (2015) Intestinal microbiota as modulators of the immune system and neuroimmune system: impact on the host health and homeostasis. J Immunol Res 2015:931574CrossRef

Guo Y, Qi Y, Yang X, Zhao L, Wen S, Liu Y et al (2016) Association between polycystic ovary syndrome and gut microbiota. PLoS ONE 11(4):e0153196CrossRef

10.

Moreno-Indias I, Sanchez-Alcoholado L, Sanchez-Garrido MA, Martin-Nunez GM, Perez-Jimenez F, Tena-Sempere M et al (2016) Neonatal androgen exposure causes persistent gut microbiota dysbiosis related to metabolic disease in adult female rats. Endocrinology 157(12):4888–4898CrossRef

11.

Tremellen K, Pearce K (2012) Dysbiosis of gut microbiota (DOGMA)—a novel theory for the development of polycystic ovarian syndrome. Med Hypotheses 79(1):104–112CrossRef

12.

Lindheim L, Bashir M, Munzker J, Trummer C, Zachhuber V, Leber B et al (2017) Alterations in gut microbiome composition and barrier function are associated with reproductive and metabolic defects in women with polycystic ovary syndrome (PCOS): a pilot study. PLoS ONE 12(1):e0168390CrossRef

13.

Torres PJ, Siakowska M, Banaszewska B, Pawelczyk L, Duleba AJ, Kelley ST et al (2018) Gut microbial diversity in women with polycystic ovary syndrome correlates with hyperandrogenism. J Clin Endocrinol Metab 103(4):1502–1511CrossRef

14.

Barazzoni R, Deutz NEP, Biolo G, Bischoff S, Boirie Y, Cederholm T et al (2017) Carbohydrates and insulin resistance in clinical nutrition: Recommendations from the ESPEN expert group. Clin Nutr 36(2):355–363CrossRef

15.

Roberfroid M, Gibson GR, Hoyles L, McCartney AL, Rastall R, Rowland I et al (2010) Prebiotic effects: metabolic and health benefits. Br J Nutr 104(Suppl 2):S1–63CrossRef

16.

Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21(11):1539–1558CrossRef

17.

Karimi E, Moini A, Yaseri M, Shirzad N, Sepidarkish M, Hossein-Boroujerdi M et al (2018) Effects of synbiotic supplementation on metabolic parameters and apelin in women with polycystic ovary syndrome: a randomised double-blind placebo-controlled trial. Br J Nutr 119(4):398–406CrossRef

18.

Karamali M, Eghbalpour S, Rajabi S, Jamilian M, Bahmani F, Tajabadi-Ebrahimi M et al (2018) Effects of probiotic supplementation on hormonal profiles, biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Arch Iran Med 21(1):1–7PubMed

19.

Ahmadi S, Jamilian M, Karamali M, Tajabadi-Ebrahimi M, Jafari P, Taghizadeh M et al (2017) Probiotic supplementation and the effects on weight loss, glycaemia and lipid profiles in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Hum Fertil (Camb) 20(4):254–261CrossRef

20.

Shoaei T, Heidari-Beni M, Tehrani HG, Feizi A, Esmaillzadeh A, Askari G (2015) Effects of probiotic supplementation on pancreatic β-cell function and C-reactive protein in women with polycystic ovary syndrome: a randomized double-blind placebo-controlled clinical trial. Int J Prev Med 6:27CrossRef

21.

Esmaeilinezhad Z, Babajafari S, Sohrabi Z, Eskandari MH, Amooee S, Barati-Boldaji R (2018) Effect of synbiotic pomegranate juice on glycemic, sex hormone profile and anthropometric indices in PCOS: A randomized, triple blind, controlled trial. Nutr Metab Cardiovasc Dis

22.

Samimi M1, Dadkhah A1, Haddad Kashani H2, Tajabadi-Ebrahimi M3, Seyed Hosseini E2, Asemi Z4. The Effects of Synbiotic Supplementation onMetabolic Status in Women With Polycystic Ovary Syndrome: a Randomized Double-Blind Clinical Trial. Probiotics and Antimicrobial Proteins 2018:doi: 10.1007/s12602–018–9405-z.

23.

Jamilian M, Mansury S, Bahmani F, Heidar Z, Amirani E, Asemi Z (2018) The effects of probiotic and selenium co-supplementation on parameters of mental health, hormonal profiles, and biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome. J Ovarian Res. 11(1):80-018-0457-1CrossRef

24.

Nasri K, Jamilian M, Rahmani E, Bahmani F, Tajabadi-Ebrahimi M, Asemi Z (2018) The effects of synbiotic supplementation on hormonal status, biomarkers of inflammation and oxidative stress in subjects with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. BMC Endocr Disord 18(1):21-018-0248-0CrossRef

25.

Ghanei N, Nima R, Ghorban AA, Farid Z, Golbou M, Esmat N (2018) The probiotic supplementation reduced inflammation in polycystic ovary syndrome: A randomized, double-blind, placebo-controlled trial. J Funct Foods 42:306–311CrossRef

26.

Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W et al (2006) Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab 91(11):4237–4245CrossRef

27.

Ahmadi S, Jamilian M, Tajabadi-Ebrahimi M, Jafari P, Asemi Z (2016) The effects of synbiotic supplementation on markers of insulin metabolism and lipid profiles in gestational diabetes: a randomised, double-blind, placebo-controlled trial. Br J Nutr 116(8):1394–1401CrossRef

28.

Lagana AS, Garzon S, Casarin J, Franchi M, Ghezzi F (2018) Inositol in polycystic ovary syndrome: restoring fertility through a pathophysiology-based approach. Trends Endocrinol Metab 29(11):768–780CrossRef

29.

Noventa M, Vitagliano A, Quaranta M, Borgato S, Abdulrahim B, Gizzo S (2016) Preventive and therapeutic role of dietary inositol supplementation in periconceptional period and during pregnancy: a summary of evidences and future applications. Reprod Sci 23(3):278–288CrossRef

30.

Backhed F, Ding H, Wang T, Hooper LV, Koh GY, Nagy A et al (2004) The gut microbiota as an environmental factor that regulates fat storage. Proc Natl Acad Sci USA 101(44):15718–15723CrossRef

31.

Billig H, Furuta I, Hsueh AJ (1993) Estrogens inhibit and androgens enhance ovarian granulosa cell apoptosis. Endocrinology 133(5):2204–2212CrossRef

32.

Lim JJ, Han CY, Lee DR, Tsang BK (2017) Ring finger protein 6 mediates androgen-induced granulosa cell proliferation and follicle growth via modulation of Androgen receptor signaling. Endocrinology 158(4):993–1004CrossRef

33.

Lim JJ, Lima PDA, Salehi R, Lee DR, Tsang BK (2017) Regulation of androgen receptor signaling by ubiquitination during folliculogenesis and its possible dysregulation in polycystic ovarian syndrome. Sci Rep. https://doi.org/10.1038/s41598-017-09880-0CrossRefPubMedPubMedCentral

34.

Xu F, Liu R, Cao X (2017) Hyperandrogenism stimulates inflammation and promote apoptosis of cumulus cells. Cell Mol Biol (Noisy-le-grand) 63(10):64–68CrossRef

35.

Welt CK, Taylor AE, Fox J, Messerlian GM, Adams JM, Schneyer AL (2005) Follicular arrest in polycystic ovary syndrome is associated with deficient inhibin A and B biosynthesis. J Clin Endocrinol Metab Oct 90(10):5582–5587CrossRef

36.

Sanchez M, Darimont C, Drapeau V, Emady-Azar S, Lepage M, Rezzonico E et al (2014) Effect of Lactobacillus rhamnosus CGMCC1.3724 supplementation on weight loss and maintenance in obese men and women. Br J Nutr 111(8):1507–1519CrossRef

37.

Gobel RJ, Larsen N, Jakobsen M, Molgaard C, Michaelsen KF (2012) Probiotics to adolescents with obesity: effects on inflammation and metabolic syndrome. J Pediatr Gastroenterol Nutr 55(6):673–678CrossRef

38.

Heshmati J, Farsi F, Yosaee S, Razavi M, Rezaeinejad M, Karimie E et al (2019) The effects of probiotics or synbiotics supplementation in women with polycystic ovarian syndrome: a systematic review and meta-analysis of randomized clinical trials. Probiotics Antimicrob Proteins 11(4):1236–1247CrossRef

39.

Ruan Y, Sun J, He J, Chen F, Chen R, Chen H (2015) Effect of probiotics on glycemic control: a systematic review and meta-analysis of randomized, controlled trials. PLoS ONE 10(7):e0132121CrossRef

40.

Sadrzadeh-Yeganeh H, Elmadfa I, Djazayery A, Jalali M, Heshmat R, Chamary M (2010) The effects of probiotic and conventional yoghurt on lipid profile in women. Br J Nutr 103(12):1778–1783CrossRef

41.

Shamasbi SG, Ghanbari-Homayi S, Mirghafourvand M (2019) The effect of probiotics, prebiotics, and synbiotics on hormonal and inflammatory indices in women with polycystic ovary syndrome: a systematic review and meta-analysis. Eur J Nutr

42.

Falcinelli S, Rodiles A, Hatef A, Picchietti S, Cossignani L, Merrifield DL et al (2017) Dietary lipid content reorganizes gut microbiota and probiotic L. rhamnosus attenuates obesity and enhances catabolic hormonal milieu in zebrafish. Sci Rep 7(1):5512CrossRef

43.

Delzenne NM, Cani PD (2011) Interaction between obesity and the gut microbiota: relevance in nutrition. Annu Rev Nutr 21(31):15–31CrossRef

Titel: Therapy with probiotics and synbiotics for polycystic ovarian syndrome: a systematic review and meta-analysis
verfasst von: Mauro Cozzolino
Amerigo Vitagliano
Livia Pellegrini
Martina Chiurazzi
Alessandra Andriasani
Guido Ambrosini
Nicolas Garrido
Publikationsdatum: 05.05.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nutrition / Ausgabe 7/2020
Print ISSN: 1436-6207
Elektronische ISSN: 1436-6215
DOI: https://doi.org/10.1007/s00394-020-02233-0

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren.

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Objective

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2020

Bifidobacteria adolescentis regulated immune responses and gut microbial composition to alleviate DNFB-induced atopic dermatitis in mice

Pelargonidin 3-glucoside-enriched strawberry attenuates symptoms of DSS-induced inflammatory bowel disease and diet-induced metabolic syndrome in rats

The ‘Seal’ of Sir Shackleton

Food insecurity is associated with lower adherence to the Mediterranean dietary pattern among Lebanese adolescents: a cross-sectional national study

Adipose tissue content of alpha-linolenic acid and development of peripheral artery disease: a Danish case-cohort study