Efeitos da suplementação de probióticos sobre a adiposidade corporal, perfil lipídico, pressão arterial e função vascular em indivíduos com hipertensão e sobrepeso ou obesidade submetidos à restrição energética

Abstract

Hypertension often clusters with other cardiovascular risk factors such as obesity, and dyslipidemia. Recently, a growing body of evidence has suggested a role of gut dysbiosis in the pathogenesis of these disorders. However, clinical trials evaluating the effects of probiotic supplementation on these outcomes present inconsistent results, probably due to the wide heterogeneity in trial designs. Therefore, the present study aimed to evaluate in individuals with hypertension and overweight or obesity, submitted to energy restriction, the effects of probiotics supplementation on body adiposity, lipid profile, blood pressure (BP) and vascular function. A randomized, controlled, parallel and double-blind clinical trial was conducted with supplementation of multiple probiotic strains for 12 weeks. Were included 66 individuals aged between 40 and 65 years; of both sexes; with body mass index ≥ 25.0 and < 40.0 kg/m² and diagnosis of hypertension. Were excluded smokers and individuals using probiotics, prebiotics, symbiotics and antibiotics; and diagnosed with diabetes, chronic kidney disease or liver failure. Participants were allocated into 2 groups: group with supplementation of 9 probiotic strains in capsules (3x1010 CFU/day) or control group (placebo capsules). Both groups followed a hypocaloric diet and were submitted to the following evaluations anthropometric, body composition (bioelectrical impedance analysis), laboratorial, dietary intake, BP, cutaneous microvascular reactivity and arterial stiffness, at baseline and after 12 weeks of intervention. Laboratory evaluation included lipid profile and serum concentration of adhesion molecules and adiponectin. Cutaneous microvascular reactivity was evaluated by the Laser Speckel Contrast Imaging technique (PeriCam PSI-NR) and arterial stiffness was evaluated by pulse wave velocity (PWV) (Mobil-O-Graph). After 12 weeks of intervention, it was observed in the probiotic group: a) reduction in body adiposity index, circumferences of waist, hip and neck, and waist-to-height ratio (p < 0.05); b) reduction of total cholesterol and triglycerides (p < 0.05); c) increase in peak perfusion during the post-occlusive reactive hyperemia (PORH) period, both when evaluated in arbitrary perfusion unit and when evaluated in cutaneous vascular conductance (p < 0.05), and significant increase in cutaneous vascular conductance, when comparing the PORH period with the basal period (p < 0.05). However, there was no significant difference between groups in any of the parameters evaluated in the study. In conclusion, in the present study, after the 12-week period of supplementation with multiple strains of probiotics associated with energy restriction in individuals with hypertension and overweight or obesity, no significant effect was found on body adiposity, lipid profile, blood pressure and vascular function.