Efeitos da suplementação de probióticos sobre a adiposidade corporal, níveis séricos de adipocinas, marcadores inflamatórios e resistência à insulina em indivíduos com hipertensão arterial e excesso de peso corporal submetidos à restrição energética

Abstract

Obesity is a public health problem, has a high and increasing prevalence worldwide, and directly contributes to cardiovascular risk factors, including dyslipidemia, type 2 diabetes mellitus (DM), hypertension leading to a higher risk of mortality. In recent years, it has been demonstrated in the literature that changes in the composition of the intestinal microbiota are associated with metabolic disorders such as obesity, hypertension and DM, as well as increased inflammation. However, clinical trials evaluating the effects of probiotic supplementation on these outcomes present inconsistent results probably due to the wide heterogeneity of the study designs. Thus, the present study aimed to evaluate the effects of probiotic supplementation on body adiposity, glucose metabolism, serum levels of adipokines and inflammatory biomarkers in individuals with hypertension and excess body weight, submitted to energy restriction. A randomized, double-blind, placebo controlled clinical trial was conducted for 12 weeks. Were included 66 individuals aged between 40 and 65 years; both sexes; body mass index (BMI) ≥ 25.0 and < 40.0 kg/m² and diagnosis of hypertension. Were excluded smokers; individuals using probiotics, prebiotics, symbiotics and antibiotics in the last 3 months; presenting DM, chronic kidney disease or liver failure; and pregnant and lactating women. Participants were allocated into 2 groups: group with supplementation of 9 probiotic strains in capsules (3 x 1010 CFU/day) or control group (placebo capsules). Both groups followed a low-calorie diet. All participants were submitted to anthropometric, body composition (bioelectrical impedance analysis - BIA and dual-energy radiological absorptiometry - DXA) and laboratory (adiponectin, leptin, tumor necrosis factor alpha, interleukin-6 and glucose metabolism) evaluation at baseline and at the end of the study. After 12 weeks of intervention, the probiotic group presented: a) reduction of body weight, BMI, circumferences of waist, hip and neck and waist-to-height ratio; b) decrease of total fat mass (kg) evaluated by DXA; and c) reduction of glycated hemoglobin (HbA1c). In the control group it was observed: a) significant reduction of all anthropometric variables; b) significant reduction of total fat mass (kg and %), trunk fat mass (kg), visceral fat and load capacity index evaluated by DXA. In both groups, there were no changes in fat mass (assessed by BIA), trunk fat mass in % (assessed by DXA), serum concentration of adipokines and proinflammatory cytokines; glucose, insulin and HOMA-IR. Thus, in conclusion, in the present study the supplementation of multiple probiotic strains associated with energy restriction in individuals with excess body weight and hypertension, during the period of 12 weeks, promoted improvement of glycemic homeostasis evaluated by HbA1c. However, no significant effects were observed on total, central and visceral body adiposity, serum concentrations of adipokines and cytokines.