The Effects of Synbiotic Supplementation on Metabolic Status in Diabetic Patients Undergoing Hemodialysis: a Randomized, Double-Blinded, Placebo-Controlled Trial

This study was conducted to evaluate the effects of synbiotic supplementation on metabolic profiles in diabetic patients undergoing hemodialysis (HD). This randomized, double-blinded, placebo-controlled clinical trial was performed in 60 diabetic HD patients. Participants were randomly assigned into two groups to receive either synbiotic capsule, containing Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidum (2 � 109 CFU/g each), plus 0.8 g/day of inulin (n = 30) or placebo (n = 30) for 12 weeks. Synbiotic supplementation significantly decreased fasting plasma glucose (β � 13.56 mg/dL; 95 CI, � 23.82, � 3.30; P = 0.01), insulin levels (β � 5.49 μIU/mL; 95 CI, � 6.92, � 4.05; P < 0.001), and insulin resistance (β � 2.25; 95 CI, � 3.02, � 1.48; P < 0.001), while increased the quantitative insulin sensitivity check index (β 0.02; 95 CI, 0.01, 0.02; P < 0.001) compared with the placebo. Additionally, synbiotic intake resulted in a significant reduction in high-sensitivity C-reactive protein (β � 2930.48 ng/mL; 95 CI, � 3741.15, � 2119.80; P < 0.001) and malondialdehyde levels (β � 0.60 μmol/L; 95 CI, � 0.99, � 0.20; P = 0.003). Moreover, we found a significant increase in total antioxidant capacity (β 142.99 mmol/L; 95 CI, 61.72, 224.25; P = 0.001) and total glutathione levels (β 131.11 μmol/L; 95 CI, 89.35, 172.87; P < 0.001) in the synbiotic group compared with the placebo group. Overall, synbiotic supplementation for 12 weeks had beneficial effects on glycemic control, biomarkers of inflammation, and oxidative stress in diabetic patients under HD. This study was registered in the Iranian website (www.irct.ir) for registration of clinical trials (http://www.irct.ir: IRCT2017090133941N17). http://www.irct.ir: IRCT2017090133941N17. © 2018, Springer Science+Business Media, LLC, part of Springer Nature

The role of vitamin D in the age of COVID-19: A systematic review and meta-analysis

Background: Evidence recommends that vitamin D might be a crucial supportive agent for the immune system, mainly in cytokine response regulation against COVID-19. Hence, we carried out a systematic review and meta-analysis in order to maximise the use of everything that exists about the role of vitamin D in the COVID-19. Methods: A systematic search was performed in PubMed, Scopus, Embase and Web of Science up to December 18, 2020. Studies focused on the role of vitamin D in confirmed COVID-19 patients were entered into the systematic review. Results: Twenty-three studies containing 11 901 participants entered into the meta-analysis. The meta-analysis indicated that 41 of COVID-19 patients were suffering from vitamin D deficiency (95 CI, 29-55), and in 42 of patients, levels of vitamin D were insufficient (95 CI, 24-63). The serum 25-hydroxyvitamin D concentration was 20.3 ng/mL among all COVID-19 patients (95 CI, 12.1-19.8). The odds of getting infected with SARS-CoV-2 are 3.3 times higher among individuals with vitamin D deficiency (95 CI, 2.5-4.3). The chance of developing severe COVID-19 is about five times higher in patients with vitamin D deficiency (OR: 5.1, 95 CI, 2.6-10.3). There is no significant association between vitamin D status and higher mortality rates (OR: 1.6, 95 CI, 0.5-4.4). Conclusion: This study found that most of the COVID-19 patients were suffering from vitamin D deficiency/insufficiency. Also, there is about three times higher chance of getting infected with SARS-CoV-2 among vitamin-D-deficient individuals and about five times higher probability of developing the severe disease in vitamin-D-deficient patients. Vitamin D deficiency showed no significant association with mortality rates in this population. © 2021 John Wiley & Sons Lt