METHODS: The Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Clinical Trials, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Scientific Electronic Library Online (SciELO) databases were searched. Randomized clinical trials of pediatric patients with DM1 using probiotics, prebiotics or symbiotics were included, regardless of year or language of publication. Studies that did not evaluate glycated hemoglobin (HbA1c) were excluded. Metabolic results (HbA1c, total insulin dose and C-peptide) and inflammatory control [interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ)] during probiotic supplementation or similar, related to modification of the intestinal microbiota, were analyzed. PROSPERO ID: CRD42022384485.
RESULTS: Five studies were selected for a systematic review. Regarding metabolic markers, only one of the articles that analyzed HbA1c showed a significant decrease (p=0.03) in the intervention group. One study identified a reduction in the total dose of insulin and increased C-peptide levels. Regarding the evaluation of inflammatory parameters (IL-10, TNF-α, INF-γ), there were no statistical relevant modifications.
CONCLUSIONS: Current data from the literature were not conclusive in identifying an improvement in glycemic control and did not observe changes in inflammatory parameters with the use of probiotics, prebiotics or symbiotics in pediatric patients with T1DM.
方法:在线医学文献分析和检索系统(MEDLINE/PubMed),临床试验,搜索了拉丁裔美国人(LILACS)和科学电子图书馆在线(SciELO)数据库。使用益生菌的DM1儿科患者的随机临床试验,包括益生元或共生元,无论年份或出版语言。未评估糖化血红蛋白(HbA1c)的研究被排除。代谢结果(HbA1c,总胰岛素剂量和C肽)和炎症控制[白细胞介素-10(IL-10),肿瘤坏死因子-α(TNF-α)和干扰素-γ(IFN-γ)]在益生菌补充或类似,与肠道微生物群的改变有关,进行了分析。PROSPEROID:CRD42022384485。
结果:选择了5项研究进行系统评价。关于代谢标志物,只有一篇分析HbA1c的文章显示干预组HbA1c显著下降(p=0.03).一项研究确定了胰岛素总剂量的减少和C肽水平的增加。关于炎症参数的评估(IL-10,TNF-α,INF-γ),没有统计学相关的修改.
结论:目前的文献数据在确定血糖控制改善方面尚无定论,也没有观察到使用益生菌时炎症参数的变化,T1DM儿科患者的益生元或共生元。