The scientists focused on postprandial (post-meal) lipid levels because they are linked to absorption of lipids in the intestine, the secretion of lipoproteins, and reportedly regulated by changes to the gut microbiota. Fasting lipid levels, on the other hand, are mainly linked to liver-derived lipoproteins, they explained.
Recent science suggests that postprandial blood lipid levels – also known as postprandial lipidemia (PL) – may be as important a risk factor for cardiovascular disease as fasting lipidemia (FL), added the researchers.
The results of the Probiotics and BBR on the Efficacy and Change of Gut Microbiota in Patients with Newly Diagnosed Type 2 Diabetes (PREMOTE) study indicated that combining berberine, an established lipid-lowering agent, with a multi-strain probiotic led to greater effects than berberine alone for lowering postprandial lipid levels, particularly for total cholesterol and LDL cholesterol.
“[O]ur study provided both clinical and experimental evidence to support the synergistic effect of supplemental empirical probiotics containing Bifidobacteria such as B. breve with BBR [berberine] in lowering PL, which could serve as an effective remedy for managing T2D [type 2 diabetes] PL and general dyslipidemia with its effect in lowering FL,” wrote the scientists in the journal Gut Microbes.
The random, placebo-controlled, and multicenter clinical trial included 365 participants, who were randomly assigned to one of four groups: Group 1 was the combination of berberine (0.6 g per 6 pills, twice daily before a meal) plus the probiotic (two sachets, once daily at bedtime); Group 2 was probiotics plus placebo; Group 3 was berberine plus placebo; and Group 4 was placebo plus placebo.
Each sachet of probiotics contained about 50 billion colony forming units (CFUs) of Bifidobacterium longum CGMCC No. 2107; B. breve CGMCC No. 6402; Lactococcus gasseri CGMCC No. 10758; Lactobacillus rhamnosus CNCM I-4474; L. salivarius CGMCC No. 6403; L. crispatus CGMCC No. 6406; L. plantarum CGMCC No. 1258; L. fermentum CGMCC No. 6407; and L. casei CNCM I-4458.
The three-month intervention showed that the combination product led to a statistically significance reduction in postprandial total cholesterol levels of -24.3 mg/dl, compared to -8.7 mg/dl in the placebo group. Additionally, postprandial LDL cholesterol levels fell by 16.5 mg/dl in the combination group, compared to 7.4 mg/dl for the placebo group, and these were greater than the changes seen in the berberine only group.
The data indicated that the combined supplement was providing a one-two punch to produce these enhanced results. In addition to berberine’s reported benefits to blood lipid levels, berberine may activate genes in the probiotics, which boost the bacteria’s ability to suppress lipid absorption in the gut.
“Our study confirmed that [berberine] and probiotic (B. breve) could exert a synergistic hypolipidemic effect on PL, acting as a gut lipid sink to achieve better lipidemia and CVD risk control in T2D,” they concluded.
Source: Gut Microbes
14:1, 2003176, DOI: 10.1080/19490976.2021.2003176
“Combined berberine and probiotic treatment as an effective regimen for improving postprandial hyperlipidemia in type 2 diabetes patients: a double blinded placebo controlled randomized study”
Authors: S. Wang, et al.