Synbiotics and pomegranate juice for polycystic ovarian syndrome

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Bezug Esmaeilinezhad Z, Babajafari S, Sohrabi Z, Eskandari M, Amooee S, Barati-Boldaji R. Wirkung von synbiotischem Granatapfelsaft auf Blutzucker, Sexualhormonprofil und anthropometrische Indizes bei PCOS: eine randomisierte, dreifach verblindete, kontrollierte Studie. (Link entfernt). 2018;29(2):201-208. Studienziel Um festzustellen, ob ein synbiotisches Granatapfelgetränk die Insulinresistenz bei Frauen mit polyzystischem Ovarialsyndrom (PCOS) verbessert; ein sekundäres Ziel war die Beurteilung von Veränderungen der Sexualhormonspiegel im Serum und anthropometrischer Messungen. Entwurf Randomisierte, dreifach verblindete, placebokontrollierte Parallelstudie Teilnehmer Die Teilnehmer wurden zwischen Januar 2017 und Juli 2017 aus der Motahari-Klinik in Shiraz, Iran, rekrutiert; 92 Frauen im Alter von 15 bis 48 Jahren erfüllten die diagnostischen …
Cover Esmaeilinezhad Z, Babajafari S, Sohrabi Z, Eskandari M, Amooee S, Barati-Boldaji R. Effect of synbiotic pomegranate juice on blood sugar, sex hormone profile and anthropometric indices at PCOS: A randomized, triple-faded, controlled study. (Link away). 2018; 29 (2): 201-208. Study destination to determine whether a synbiotic pomegranate drink improves insulin resistance in women with polycystic ovarian syndrome (PCOS); A secondary goal was to assess changes in sex hormone levels in serum and anthropometric measurements. Designed randomized, three-fold, placebo-controlled parallel study participants The participants were recruited between January 2017 and July 2017 from the Motahari Clinic in Shiraz, Iran; 92 women between the ages of 15 and 48 met the diagnostic ... (Symbolbild/natur.wiki)

reference

Esmaeilinezhad Z, Babajafari S, Sohrabi Z, Eskandari M, Amooee S, Barati-Boldaji R. Effect of synbiotic pomegranate juice on blood sugar, sex hormone profile and anthropometric indices at PCOS: A randomized, triple-faded, controlled study. (Link away). 2018; 29 (2): 201-208.

Study goal

to determine whether a synbiotic pomegranate drink improves insulin resistance in women with polycystic ovarian syndrome (PCOS); A secondary goal was the assessment of changes in sex hormone levels in serum and anthropometric measurements.

draft

randomized, triple -blinded, placebo -controlled parallel study

participant

The participants were recruited between January 2017 and July 2017 from the Motahari Clinic in Shiraz, Iran; 92 women between the ages of 15 and 48 met the diagnostic criteria for PCOS and 86 completed the study. The Rotterdam criteria for PCOS are fulfilled if 2 or more of the following features are present and other possible causes were excluded: 1) Oligo or Anovulation; 2) clinical or laboratory findings of hyperandrogenism; 3) Several ovarian cysts that were observed in ultrasound.

women were excluded from the study when they were smokers, breastfeeding, had a serious illness (including autoimmunity and significant organ dysfunction) or received certain interventions (including chemotherapy, corticosteroids, antibiotics, hormones and additional vitamins, minerals or antioxidants). . The researchers also excluded people with "special nutrition and physical activity", but did not go into this statement.

Intervention

The participants were randomized in 4 study groups, which were delimited by the intervention obtained: synbiotic pomegranate juice (SPJ); Synbiotic drink (SB); Pomegranate juice (PJ); and placebo (control).

The synbiotic pomegranate drink consisted of pomegranate juice, inulin (20 g/l) and equal parts of 3 types of bacteria: lactobacillus rhamnosus gg, bacillus coagulans and bacillus indicus (10 8 colony -image units [CFU]/g/l). The synbiotic drink had the same concentration of inulin and lactobacilli, but on a water -based plus pomegranate taste. The drinks were freshly prepared during the experiment. The placebo drink was water plus pomegranate aroma, and the pomegranate drink was pure juice. The participants consumed 2 liters of their drink per week for 8 weeks.

study parameters evaluated

The researchers measured the sober blood levels of insulin, glucose, overall testosterone, luteinizing hormone (LH) and follicle -stimulating hormone (FSH) at the beginning of the study and after 8 weeks. Using sober glucose and insulin, they calculated the evaluation of the homeostatic model for insulin resistance (Homa-IR) and the quantitative insulin sensitivity check index (Quicki). They also carried out 3-day diet recalls and measured the BMI, the waist size and the hip size at the start of the course and after 8 weeks.

primary result measurements

The primary result of the study is the insulin resistance, measured with Homa-IR. Secondary endpoints were blood sugar, insulin, overall testosterone, LH and FSH.

important knowledge

The statistical analysis was carried out using intergroup parameters, whereby the control group served as a comparison group. A statistically significant reduction in insulin resistance (Homa-IR) was observed in the SPJ and SB groups by the Baseline for up to 8 weeks ( p <0.05).

In a similar way, insulin sensitivity (as rated based on the Quicki scores) increased significantly in these 2 groups compared to the control group ( p <0.05). This was reflected in the reduction of the sober insulin and glucose in these groups, but the reduction of the sober insulin was only statistically significant in the SB group.

The researchers put the hypothesis that these different mechanisms would cause synergistic effects if they were combined; However, no major improvement in the synbiotic + pomegranate juice group was observed to the SB group, with the exception of the waist hip circumference.

In terms of the anthropometric changes, BMI, weight and waist size in the SPJ and SB groups significantly decreased ( p <0.05). There was no significant change in the scope of hip, but the ratio of waist to hip decreased in the SPJ group. The overall testosterone fell in the SPJ and SB groups ( p <0.05), but there was no significant change from FSH or LH.

practice implications

It is assumed that synbiotics are advantageous due to their effects on carbohydrate metabolism, which is an advantage of insulin sensitivity and inflammation for PCOS. These effects are achieved by increased production of glucagon-like peptide-1 (GLP-1), short-chain fatty acids (SCFAS) and natural killer cells. 1,2 It is also assumed that pomegranate juice (in particular its Punicin and Catalpine acid components) improves insulin sensitivity and reduces inflammation, However, through other mechanisms, including the high regulation of the peroxisoma proliferator-activated receptor gammas (PPAR-γ) and the reduction of the tumor necrosis factor alpha (TNF-). α). 3

The researchers put the hypothesis that these different mechanisms would cause synergistic effects if they were combined; However, no major improvement in the synbiotic + pomegranate juice group was observed to the SB group, with the exception of the waist-hip circumference. The authors attribute the lack of improvement to the short duration of study and suspect that a longer study would show differences between these interventions. However, the pomegranate juice (PJ) group did not see any improvements in one of the evaluated result measurements, and it does not seem to be advisable to rely on a person with insulin resistance to a regime that-according to the United States (USDA)-estimated 279 g of carbohydrates (269 g of sugar) to their weekly macro nutritional absorption without clear data without clear data occupy independent benefits.

Would insulin resistance improve if used for a long time? It is a question that is worth asking in future research.

When pomegranate juice is removed from the equation, the question arises: Is there an advantage to give synbiotics via drinks instead of capsules? The latter offers a simple and consistent dosage and possibly a better submission of organisms to the large intestine if it is coated with gastrointestinal resistant. However, in order to obtain sufficient amounts of inulin, it would probably be necessary to add a dietary supplement in powder form. A recently carried out meta -analysis and systematic review of probiotics and synbiotics in PCOS showed only negligible advantages of these nutritional supplements in terms of metabolic metrics. determined. 5 The confusion could be attributed to the variability in the composition and effectiveness of the probiotics/synbiotics examined. A study that showed advantages for Homa-IR and other metabolic parameters used a synbiotic with lactobacillus acidophilus , l Casei , bifidobacterium bifidum and inulin in a concentration of 2 billion cfu or 800 mg. Study that found advantages for Apelin-36 (a peptide with an impact on metabolic and cardiovascular health), but not Homa-IR or inflammatory markers, used a mixture of l acidophilus , l caseei l. Bulgaricus , l Rhamnosus , b Lang , b Krey and streptococcus thermophilus with inulin. 7

The reduction of the serum testosterone in the SPJ and SB groups is a fascinating secondary finding of this study. Further research is justified in order to determine whether this reduction leads to an improvement in the symptoms of hyperandrogenism, including acne, deerutism and oligo/anovulation. A study containing a synbiotic l acidophilus , l Casei , b bifidum (2 billion CFU) and inulin (800 mg) in addition to sex hormone and inflammatory markers showed a reduction in the modified Ferriman Gallwey-Scores Hirsutism. 8

In view of the growing number of research results, which show the advantages of probiotics and synbiotics for a variety of diseases and a minimal risk of side effects, a 12-week attempt with synbiotics with inulin and a mixture of lactobacilli and bifidobacterium types at PCOS. Possible advantages are an improvement in insulin resistance, BMI, waist circumference and the symptoms of hyperandrogenism. From the present research, there is no mandatory reason to combine synbiotics with pomegranate juice in the treatment of PCOS.

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