The effects of probiotic and selenium co-supplementation on mental health parameters and metabolic profiles in type 2 diabetic patients with coronary heart disease: A randomized, double-blind, placebo-controlled trial

Abstract

Background and aims: The objective of this investigation was to assess the effects of probiotic and selenium co-supplementation on indicators of mental health and metabolic profiles in diabetic people with coronary heart disease (CHD).

Methods: This randomized, double-blind, placebo-controlled trial was conducted among 54 diabetic people with CHD. Patients were randomly allocated into two groups to receive either 200 μg/day selenium plus 8 × 10⁹ CFU/day probiotic (n = 27) or placebo (n = 27) for 12 weeks.

Results: Probiotic and selenium co-supplementation significantly decreased Beck Depression Inventory index (β -1.46; 95% CI, -2.61, -0.31; P = 0.01) and Beck Anxiety Inventory index (β -1.23; 95% CI, -2.33, -0.12; P = 0.02) compared with the placebo. Consuming probiotic plus selenium lowered fasting plasma glucose (β -10.80 mg/dL; 95% CI, -17.68, -3.92; P = 0.003), serum insulin levels (β -3.42 μIU/mL; 95% CI, -4.93, -1.90; P < 0.001), insulin resistance (β -0.96; 95% CI, -1.45, -0.47; P < 0.001), and enhanced insulin sensitivity (β 0.01; 95% CI, 0.007, 0.01; P < 0.001) compared with the placebo. Additionally, co-supplementation reduced triglycerides (β -34.45 mg/dL; 95% CI, -56.18, -12.72; P = 0.003), VLDL- (β -6.89 mg/dL; 95% CI, -11.23, -2.54; P = 0.003), total cholesterol (β -18.13 mg/dL; 95% CI, -23.42, -2.83; P = 0.02) and high sensitivity C-reactive protein (β -1043.28 ng/mL; 95% CI, -1929.67, -156.89; P = 0.02), and increased nitric oxide (β 7.86 μmol/L; 95% CI, 5.63, 10.09; P < 0.001), total antioxidant capacity (β 119.30 mmol/L; 95% CI, 63.04, 175.57; P < 0.001) and total glutathione (β 154.16 μmol/L; 95% CI, 82.57, 225.74; P < 0.001) compared with the placebo.

Conclusions: Probiotic and selenium co-supplementation to diabetic people with CHD improved indicators of mental health and metabolic profiles. Registered under Clinical Trials.gov Identifier no. http://www.irct.ir: IRCT20170513033941N28.

Keywords: Diabetes mellitus; Mental health; Metabolic profiles; Probiotic; Selenium.