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Protective effect of probiotics in patients with non-alcoholic fatty liver disease.
Cai, GS, Su, H, Zhang, J
Medicine. 2020;99(32):e21464
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Non-alcoholic fatty liver disease (NAFLD) is common in people with obesity and is characterised by high amounts of fat stored in the liver. Diet and exercise are the standard treatments, however recent studies have indicated that the gut microbiota may have an important role. This randomised control trial of 140 patients with NAFLD, aimed to assess the effect of probiotics when added to standard therapy for 3 months. The results showed that although gut microbiota, some aspects of liver function, blood lipids and blood sugars were all improved in individuals on standard therapy, there were additional improvements in those on standard therapy plus probiotics. It was concluded that although standard therapy alone is adequate to improve NAFLD, probiotics plus standard therapy was superior to standard therapy alone and effective in treatment of NAFLD. This study could be used by health professionals to justify the addition of probiotics to standard therapy to further improve NAFLD outcomes.
Abstract
To investigate the effects of probiotics on liver function, glucose and lipids metabolism, and hepatic fatty deposition in patients with non-alcoholic fatty liver disease (NAFLD).Totally 140 NAFLD cases diagnosed in our hospital from March 2017 to March 2019 were randomly divided into the observation group and control group, 70 cases in each. The control group received the diet and exercise therapy, while the observation group received oral probiotics based on the control group, and the intervention in 2 groups lasted for 3 months. The indexes of liver function, glucose and lipids metabolism, NAFLD activity score (NAS), and conditions of fecal flora in 2 groups were compared before and after the treatment.Before the treatment, there were no significant differences on alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamine transferase (GGT), total bilirubin (TBIL), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), insulin resistance index (HOMA-IR), NAFLD activity score (NAS), and conditions of fecal flora in 2 groups (P > .05). After the treatment, ALT, AST, GGT, TC, TG, HOMA-IR, NAS, and conditions of fecal flora in the observation group were better than those in the control group, and the observation group was better after treatment than before. All these above differences were statistically significant (P < .05).Probiotics can improve some liver functions, glucose and lipids metabolism, hepatic fatty deposition in patients with NAFLD, which will enhance the therapeutic effects of NAFLD.
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Fecal Microbiome and Food Allergy in Pediatric Atopic Dermatitis: A Cross-Sectional Pilot Study.
Fieten, KB, Totté, JEE, Levin, E, Reyman, M, Meijer, Y, Knulst, A, Schuren, F, Pasmans, SGMA
International archives of allergy and immunology. 2018;175(1-2):77-84
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Atopic diseases, such as atopic dermatitis (AD), asthma and rhinitis, are on the increase worldwide. Exposure to microbes may be important in the development of an atopic disease. Specifically, reduced early-life exposure is thought to be a contributing factor because microbial colonisation of the intestines during infancy plays a crucial role in the maturation of the immune system. AD, also called eczema, is an inflammatory skin disease often seen in small children. Food allergies are common in children with AD, the most common allergens being eggs, cow’s milk, peanuts, soy and wheat. This cross-sectional observational pilot study with 82 young children with a diagnosis of AD set out to identify distinct microbial patterns in the children’s faecal microbiomes associated with a clinical diagnosis of food allergy. Stool and blood samples were collected for a microbiome analysis and IgE antibody measurement, respectively. 20 children had a confirmed food allergy (most commonly to cow’s milk and peanuts), while almost half of the children without a diagnosed food allergy were sensitised to common food allergens after a food challenge. The study identified a faecal microbial signature in children with AD that differentiates between the presence and absence of food allergy. Children with AD and food allergy had more Escherichia coli and Bifidobacterium pseudocatenulatum species and less Bifidobacterium breve, Faecalibacterium prausnitzii and Akkermansia muciniphila species than children without food allergy. The authors concluded that the study supports a hypothesis that the intestinal microbiome differs in children with AD, depending on whether they have a food allergy or not. They call for future studies to confirm these findings.
Abstract
BACKGROUND Exposure to microbes may be important in the development of atopic disease. Atopic diseases have been associated with specific characteristics of the intestinal microbiome. The link between intestinal microbiota and food allergy has rarely been studied, and the gold standard for diagnosing food allergy (double-blind placebo-controlled food challenge [DBPCFC]) has seldom been used. We aimed to distinguish fecal microbial signatures for food allergy in children with atopic dermatitis (AD). METHODS Pediatric patients with AD, with and without food allergy, were included in this cross-sectional observational pilot study. AD was diagnosed according to the UK Working Party criteria. Food allergy was defined as a positive DBPCFC or a convincing clinical history, in combination with sensitization to the relevant food allergen. Fecal samples were analyzed using 16S rRNA microbial analysis. Microbial signature species, discriminating between the presence and absence food allergy, were selected by elastic net regression. RESULTS Eighty-two children with AD (39 girls) with a median age of 2.5 years, and 20 of whom were diagnosed with food allergy, provided fecal samples. Food allergy to peanut and cow's milk was the most common. Six bacterial species from the fecal microbiome were identified, that, when combined, distinguished between children with and without food allergy: Bifidobacterium breve, Bifidobacterium pseudocatenulatum, Bifidobacterium adolescentis, Escherichia coli, Faecalibacterium prausnitzii, and Akkermansia muciniphila (AUC 0.83, sensitivity 0.77, specificity 0.80). CONCLUSIONS In this pilot study, we identified a microbial signature in children with AD that discriminates between the absence and presence of food allergy. Future studies are needed to confirm our findings.
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[Type 2 Diabetes Mellitus, Depression and Eating Disorders in Patients Submitted to Bariatric Surgery].
Brandão, I, Marques Pinho, A, Arrojado, F, Pinto-Bastos, A, Maia da Costa, J, Coelho, R, Calhau, C, Conceição, E
Acta medica portuguesa. 2016;29(3):176-81
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Bariatric surgery has become the most efficient way to obtain satisfying results in terms of weight loss, comorbidity improvement and survival amongst people with morbid obesity. The aim of the study is to assess the progression of type 2 diabetes and psychopathological variables before and after bariatric surgery. A secondary aim is to analyse the importance of the different variables in weight loss outcomes. The retrospective observational and cross-sectional study involves clinical data of 75 patients, aged between 23 and 64, before and after bariatric surgery. Results indicate that type 2 diabetes improved through bariatric surgery, and that type 2 diabetes, depression and eating disorders have an influence on weight loss postoperatively. Authors conclude that it is important to provide continuous psychiatric follow-up of patients who undergo bariatric surgery.
Abstract
INTRODUCTION Obesity is associated with a great number of complications, including type 2 diabetes mellitus and psychiatric pathology. Bariatric surgery is the best solution to weight loss and improvement of complications in morbid obese patients. This study aims to analyze the evolution of type 2 diabetes mellitus and psychopathologic variables before and after bariatric surgery and assess the importance of different variables in weight loss. MATERIAL AND METHODS This is a longitudinal study, which evaluates 75 patients before and after bariatric surgery (47 - LAGB - laparoscopic adjustable gastric band; 19 - RYGB - Roux-en-Y gastric bypass; 9 - sleeve) with a follow-up time between 18 and 46 months. A clinical interview and self report questionnaires were applied - Eating Disorder Examination questionnaire - EDE-Q and Beck Depression Inventory - BDI. RESULTS Results show an improvement in type 2 diabetes mellitus after surgery (X2 (1) = 26.132, p < 0.001). There was not a significant improvement among psychiatric pathology when we controlled the analysis for the type of surgery. It was verified that type 2 diabetes mellitus, depression and eating disorders in post-operative period are associated with less weight loss. This model explains 27% of weight variance after surgery (R2 = 0.265) and it is significant F (3.33) = 2.981, p = 0.038. DISCUSSION Type 2 diabetes mellitus, psychiatric pathology and eating disorders after surgery influenced weight loss. It was not clear in what way this relation was verified, neither the relation that these metabolic and psychological variables may have during the postoperative period. CONCLUSION Type 2 diabetes mellitus improved after surgery. Type 2 diabetes mellitus, depression and eating disorders influenced weight loss in the postoperative period. These variables did not influence weight loss in the preoperative period. Introdução: A obesidade associa-se a um elevado número de comorbilidades, entre as quais a diabetes mellitus tipo 2 e a patologia psiquiátrica. A cirurgia bariátrica tem demonstrado ser a melhor solução para a perda de peso e a melhoria das complicações nos casos de obesidade mórbida. O objetivo deste estudo é o de analisar a evolução da diabetes mellitus tipo 2 e de variáveis psicopatológicas antes e depois da cirurgia bariátrica e verificar o seu impacto na perda de peso. Material e Métodos: É um estudo longitudinal, que avalia 75 indivíduos antes e depois de serem submetidos a cirurgia bariátrica (47 - banda gástrica; 19 - bypass Roux-en-Y gástrico; 9 - sleeve gástrico), com tempo de follow-up entre 18 e 46 meses. Os instrumentos de avaliação foram a entrevista clínica e os questionários Eating Disorder Examination questionnaire - EDE-Q e Beck Depression Inventory - BDI. Resultados: Verificou-se melhoria relativamente à variável dicotómica diabetes mellitus tipo 2 após a cirurgia (X(1) = 26,132, p < 0,001). Não ocorreu melhoria significativa em termos de patologia psiquiátrica quando a análise foi controlada para o tipo de cirurgia. Encontrámos uma associação significativa entre as variáveis em estudo no pós-cirúrgico e a perda de peso. Este modelo explica 27% da variação do peso após a cirurgia (R2 = 0,265) e é significativo F (3,33) = 2,981, p = 0,038. Discussão: A diabetes mellitus tipo 2, patologia depressiva ou do comportamento alimentar mostraram estar relacionados com a perda de peso. Não ficou esclarecido em que sentido esta relação é estabelecida, nem a relação que estas variáveis metabólicas e psicológicas possam ter entre si ao longo do período pós cirurgia bariátrica. Conclusão: A diabetes mellitus tipo 2 evoluiu favoravelmente após a cirurgia. Diabetes mellitus tipo 2, depressão e patologia alimentar no período pós-cirúrgico associaram-se a menor perda de peso. As variáveis estudadas no período pré cirúrgico não contribuíram de forma significativa para a perda de peso.
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Modifying influence of dietary sugar in the relationship between cortisol and visceral adipose tissue in minority youth.
Gyllenhammer, LE, Weigensberg, MJ, Spruijt-Metz, D, Allayee, H, Goran, MI, Davis, JN
Obesity (Silver Spring, Md.). 2014;22(2):474-81
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Visceral adipose tissue (VAT) is one of the strongest risk factors associated with obesity and related co-morbidities. A potential mechanism for this association involves cortisol and cortisol receptors, however the specific interaction of cortisol and diet upon fat deposition has not yet been explored in humans. The purpose of this cross-sectional study was to assess the impact of a high-fat, high-sugar diet on the association between stress and visceral fat in 165 overweight minority youth. The results of this study showed that cortisol was significantly associated with elevated VAT under conditions of high sugar intake in this population. Based on these findings, the authors conclude that dietary sugar may play a crucial role in moderating the adverse effects of cortisol.
Abstract
OBJECTIVE Cortisol has been associated with preferential visceral adipose tissue (VAT) deposition; however, findings in humans are mixed, which may be clarified when diet is considered. DESIGN AND METHODS Participants included 165 African-American and Latino, overweight adolescents (BMI% 97.2±3.2%, ages 13-18, 67% Latino, 66% female). Body composition was determined by dual energy X-ray absorptiometry, abdominal fat depots [VAT, subcutaneous (SAT)] by multiple-slice MRI, time-controlled serum sample to measure cortisol, and 2-day multi-pass 24-hour dietary recall. Linear regression analysis examined the cross-sectional relationship between cortisol, and the interaction of diet and cortisol on adiposity measures. Sex, race, age, and total body fat were a priori covariates. RESULTS There was a significant interaction between cortisol and sugar (total and added) in the prediction of VAT (P(interaction) ≤ 0.05). Amongst participants with high total or added-sugar intake, cortisol was significantly associated with VAT (ß = 0.031 P < 0.001; ß = 0.026 P < 0.001), with no relationship in low consumers of total or added-sugar. CONCLUSION Dietary sugar may play an important role in modifying the relationship between cortisol and VAT, such that cortisol is significantly associated with elevated VAT under conditions of high sugar intake.