The Effect of Probiotics on Cardiovascular Risk Factors in Patients with Major Depressive Disorder: A Randomized Clinical Trial Study

Document Type : Original Article (s)

10.22122/jims.v39i618.13717

Abstract

Background: Depression has been associated with cardiovascular disease in previous research. They also have stated that probiotics have a protective effect against cardiovascular disease. The aim of this study was to investigate the role of probiotics in this association.
Methods: In this study, fifty patients with major depressive disorder (MDD) who were candidates for fluoxetine were randomly selected and divided into two groups. One group received fluoxetine (20 mg) with a probiotic supplement which contained Lactobacillus holoticus and Bifidobacterium langum (2 × 109 CFU/g for each) and another group received fluoxetine with a placebo during 8-week period. 10 ml of fasting blood was taken from patients for biochemical measurements.
Findings: After 8 weeks of intervention, patients in the probiotic group had significant decrease in serum high-sensitivity C-reactive protein (hs-CRP) levels compared with the placebo group (2.599± 0.990 vs. 2.704 ± 1.361 ng/ml, P = 0.017). At the end of the study, although, there was significant increase in catalase (30.06 ± 3.443 vs. 26.24 ± 6.908 U, P = 0.037) and decrease in malondialdehyde (MDA) (15.13 ± 3.574vs. 17.40 ± 3.170 mg/dl, P = 0.029) levels in the probiotic group, but after 8 weeks, there was no significant difference between the two groups. Other variables did not change significantly.
Conclusion: Although probiotics can improve cardiovascular status by reducing general inflammation in the body, they are not specifically associated with lower risk of cardiovascular diseases.

Keywords


Kessler RC, Bromet EJ. The epidemiology of depression across cultures. Annu Rev Public Health 2013; 34: 119-38.
Wang J, Wu X, Lai W, Long E, Zhang X, Li W, et al. Prevalence of depression and depressive symptoms among outpatients: A systematic review and meta-analysis. BMJ Open 2017; 7(8): e017173.
Hasin DS, Sarvet AL, Meyers JL, Saha TD, Ruan WJ, Stohl M, et al. Epidemiology of adult DSM-5 major depressive disorder and its specifiers in the United States. JAMA Psychiatry 2018; 75(4): 336-46.
Seedat S, Scott KM, Angermeyer MC, Berglund P, Bromet EJ, Brugha TS, et al. Cross-national associations between gender and mental disorders in the World Health Organization World Mental Health Surveys. Arch Gen Psychiatry 2009; 66(7): 785-95.
Hunter DJ, Reddy KS. Noncommunicable diseases. N Engl J Med 2013; 369(14): 1336-43.
World Health Organization. Hearts: Technical package for cardiovascular diseasemanagement in primary health care. Geneva, Switzerland: WHO; 2016.
Gandomkar A, Poustchi H, Moini M, Moghadami M, Imanieh H, Fattahi MR, et al. Pars cohort study of non-communicable diseases in Iran: protocol and preliminary results. Int J Public Health 2017; 62(3): 397-406.
World Health Organization. Regional Office for South-East Asia. Conquering depression: you can get out of the blues. New Delhi, India: WHO Regional Office for South-East Asia; 2001.
Huang R, Wang K, Hu J. Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2016; 8(8): 483.
Akkasheh G, Kashani-Poor Z, Tajabadi-Ebrahimi M, Jafari P, Akbari H, Taghizadeh M, et al. Clinical and metabolic response to probiotic administration in patients with major depressive disorder: A randomized, double-blind, placebo-controlled trial. Nutrition 2016; 32(3): 315-20.
Moradi-Lakeh M, Vosoogh-Moghaddam A. Health sector evolution plan in iran; equity and sustainability concerns. Int J Health Policy Manag 2015; 4(10): 637-40.
Ahire JJ, Mokashe NU, Patil HJ, Chaudhari BL. Antioxidative potential of folate producing probiotic Lactobacillus helveticus CD6. J Food Sci Technol 2013; 50(1): 26-34.
Ejtahed HS, Mohtadi-Nia J, Homayouni-Rad A, Niafar M, Asghari-Jafarabadi M, Mofid V. Probiotic yogurt improves antioxidant status in type 2 diabetic patients. Nutrition 2012; 28(5): 539-43.
Tsuda H, Miyamoto T. Production of exopolysaccharide by lactobacillus plantarum and the prebiotic activity of the exopolysaccharide. Food Science and Technology Research 2010; 16(1): 87-92.
Chamari M, Djazayery A, Jalali M, Yeganeh H, Hosseini S, Heshmat R. The effect of daily consumption of probiotic and conventional yogurt on some oxidative stress factors in plasma of young healthy women. ARYA Atheroscler J 2008; 4(4): 175-9.
Jones ML, Martoni CJ, Prakash S. Cholesterol lowering and inhibition of sterol absorption by Lactobacillus reuteri NCIMB 30242: a randomized controlled trial. Eur J Clin Nutr 2012; 66(11): 1234-41.
Halperin D, Reber G. Influence of antidepressants on hemostasis. Dialogues Clin Neurosci 2007; 9(1): 47-59.
Barreto FM, Colado Simao AN, Morimoto HK, Batisti Lozovoy MA, Dichi I, Helena da Silva ML. Beneficial effects of Lactobacillus plantarum on glycemia and homocysteine levels in postmenopausal women with metabolic syndrome. Nutrition 2014; 30(7-8): 939-42.
Valentini L, Pinto A, Bourdel-Marchasson I, Ostan R, Brigidi P, Turroni S, et al. Impact of personalized diet and probiotic supplementation on inflammation, nutritional parameters and intestinal microbiota - The "RISTOMED project": Randomized controlled trial in healthy older people. Clin Nutr 2015; 34(4): 593-602.
Milajerdi A, Mousavi SM, Sadeghi A, Salari-Moghaddam A, Parohan M, Larijani B, et al. The effect of probiotics on inflammatory biomarkers: a meta-analysis of randomized clinical trials. Eur J Nutr 2020; 59(2): 633-49.
Shamasbi SG, Ghanbari-Homayi S, Mirghafourvand M. The effect of probiotics, prebiotics, and synbiotics on hormonal and inflammatory indices in women with polycystic ovary syndrome: a systematic review and meta-analysis. Eur J Nutr 2020; 59(2): 433-50.
de Roos NM, van HS, Rovers JMP, Smits MG, Witteman BJM. The effects of a multispecies probiotic on migraine and markers of intestinal permeability-results of a randomized placebo-controlled study. Eur J Clin Nutr 2017; 71(12): 1455-62.
Maes M, Mihaylova I, Kubera M, Uytterhoeven M, Vrydags N, Bosmans E. Increased plasma peroxides and serum oxidized low density lipoprotein antibodies in major depression: markers that further explain the higher incidence of neurodegeneration and coronary artery disease. J Affect Disord 2010; 125(1-3): 287-94.
Kullisaar T, Songisepp E, Aunapuu M, Kilk K, Arend A, Mikelsaar M, et al. Complete glutathione system in probiotic Lactobacillus fermentum ME-3. Prikl Biokhim Mikrobiol 2010; 46(5): 527-31.
Heshmati J, Farsi F, Shokri F, Rezaeinejad M, Almasi-Hashiani A, Vesali S, et al. A systematic review and meta-analysis of the probiotics and synbiotics effects on oxidative stress. Journal of Functional Foods 2018; 46: 66-84.
Galecki P, Szemraj J, Bienkiewicz M, Florkowski A, Galecka E. Lipid peroxidation and antioxidant protection in patients during acute depressive episodes and in remission after fluoxetine treatment. Pharmacol Rep 2009; 61(3): 436-47.
Barim AO, Aydin S, Colak R, Dag E, Deniz O, Sahin
I. Ghrelin, paraoxonase and arylesterase levels in depressive patients before and after citalopram treatment. Clin Biochem 2009; 42(10-11): 1076-81.
Kotan VO, Sarandol E, Kirhan E, Ozkaya G, Kirli S. Effects of long-term antidepressant treatment on oxidative status in major depressive disorder: a 24-week follow-up study. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35(5): 1284-90.