The effect of early enteral nutrition supplemented with synbiotics on lipid and glucose homeostasis in critically ill patients: A randomized controlled trial

Diabetes Metab Syndr. 2022 Jan;16(1):102352. doi: 10.1016/j.dsx.2021.102352. Epub 2021 Nov 26.

Abstract

Background and aims: The aim of the present study was to investigate the effects of gut microbiota modulation through synbiotic supplementation on lipid and glucose homeostasis in tube-fed critically-ill adult patients.

Methods: This study is placebo-controlled, parallel, single-center, double-blind clinical trial. 42 patients were randomly distributed in placebo and synbiotic groups to receive intervention for a maximum of 14 days. Serum levels of fasting glucose, total cholesterol, and triglycerides, insulin, and free fatty acids were obtained from blood sampling at baseline and the end of the study. Also, insulin resistance was determined by homeostasis model assessment of insulin resistance (HOMA-IR).

Result: Fasting glucose level (Day0 = 87.84 ± 15.51, Day14 = 83.76 ± 8.71 mg/dl, P = 0.51), fasting insulin level (Day0 = 9.46 ± 7.31, Day14 = 7.97 ± 5.19 mIU/L, P = 1.00), and HOMA index (Day0 = 1.89 ± 1.48, Day14 = 1.72 ± 1.17, P = 0.75) during the study were decreasing in both groups, but the decreases were not significant. Serum levels of total cholesterol, triglyceride, and free fatty acidsat the beginning of the study were 114.18 ± 43.43 mg/dl, 146.59 ± 53.99 mg/dl, 0.83 ± 0.57 mmol/L, and at the end of the study were 129.10 ± 39.05 mg/dl, 127.40 ± 91.88 mg/dl, 0.88 ± 0.77 mmol/L, respectively. None of these changes were significant either (P = 0.99, P = 0.38, P = 0.90, respectively).

Conclusions: According to our findings, synbiotics supplementation in critically ill patients has no significant effect on lipid and glucose profile.

Keywords: Cardiovascular markers; Critical illness; Glucose homeostasis; Lipid profile homeostasis; Probiotic; Synbiotic.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Blood Glucose
  • Critical Illness / therapy
  • Dietary Supplements
  • Double-Blind Method
  • Enteral Nutrition
  • Homeostasis
  • Humans
  • Insulin
  • Insulin Resistance*
  • Synbiotics*
  • Triglycerides

Substances

  • Blood Glucose
  • Insulin
  • Triglycerides