Effects of probiotics, prebiotics and synbiotics supplementation on cardiovascular risk factors in patients with type 2 diabetes mellitus: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials
Bibliographic record
Abstract
A systematic review and meta-analysis study was conducted to assess the effectiveness of probiotic/prebiotic/synbiotic supplementation on the effects of cardiovascular risk factors in patients with type 2 diabetes mellitus (T2DM) based on data from randomized controlled trials (RCTs). We searched electronic databases including PubMed, Cochrane Library, Embase, and Web of Science to identify clinical trials published up to 31 March 2023. Data was pooled using a random-effects model if significant heterogeneity (I² > 50%), otherwise use a fixed-effects model. Fifty-six trials that included 3 317 patients were enrolled for analysis. Meta-analysis reported that probiotic/prebiotic/synbiotic supplementation significantly reduced systolic blood pressure (SBP) (weighted mean difference (WMD): −3.57 mmHg, 95% confidence interval (CI): −5.36, −1.78; P = 0.000), diastolic blood pressure (DBP) (WMD: −2.05 mmHg, 95% CI: −3.07, −1.04; P = 0.000), triglycerides (TG) (WMD: −16.10 mg/dL, 95% CI: −20.16, −12.05; P = 0.000), total cholesterol (TC) (WMD: −14.00 mg/dL, 95% CI: −20.46, −7.55; P = 0.000), low-density lipoprotein cholesterol (LDL-C) (WMD: −7.03 mg/dL, 95% CI: −9.25, −4.81; P = 0.000), fasting plasma glucose (FPG) (WMD: −16.57 mg/dL, 95% CI: −20.39, −12.74; P = 0.000), hemoglobin A1c (HbA1c) (WMD: −0.44%, 95% CI: −0.68, −0.20; P = 0.000), insulin (standardized mean difference (SMD): −0.37, 95% CI: −0.53, −0.21; P = 0.000), homeostatic model assessment of insulin resistance (HOMA-IR) (WMD: −1.05, 95% CI: −1.56, −0.54; P = 0.000), C-reactive protein (CRP) (SMD: −0.35, 95% CI: −0.57, −0.13; P = 0.002), tumor necrosis factor-α (TNF-α) (SMD: −1.07, 95% CI: −1.57, −0.56; P = 0.000), interleukin-6 (IL-6) (SMD: −0.37 , 95% CI: −0.61, −0.13; P = 0.003) levels, they also increased the high-density lipoprotein cholesterol (HDL-C) (WMD: 3.70 mg/dL, 95% CI: 1.80, 5.60; P = 0.000) levels in T2DM patients, as compared to the placebo groups. This meta-analysis supports the use of probiotic/prebiotic/synbiotic supplementation as an adjunctive therapy to improve blood pressure, glycemic control parameters, lipid profile and inflammatory markers in patients with T2DM, which are well-known cardiovascular risk factors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.037 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.027 | 0.044 |
| Bibliometrics | 0.009 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".