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

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 mu g/day selenium plus 8 x 10(9) CFU/day probiotic (n = 27) or placebo (n = 27) for 12 weeks. Results: Probiotic and selenium co-supplementation significantly decreased Beck Depression Inventory index (beta -1.46; 95% CI, -2.61, -0.31; P = 0.01) and Beck Anxiety Inventory index (beta -1.23; 95% CI, -2.33, -0.12; P = 0.02) compared with the placebo. Consuming probiotic plus selenium lowered fasting plasma glucose (beta -10.80 mg/dL; 95% CI, -17.68, -3.92; P = 0.003), serum insulin levels (beta -3.42 mu IU/mL; 95% CI, -4.93, -1.90; P < 0.001), insulin resistance (beta -0.96; 95% CI, -1.45, -0.47; P < 0.001), and enhanced insulin sensitivity (beta 0.01; 95% CI, 0.007, 0.01; P < 0.001) compared with the placebo. Additionally, co-supplementation reduced triglycerides (beta -34.45 mg/cIL; 95% CI, -56.18, -12.72; P = 0.003), VLDL- (beta -6.89 mg/dL; 95% CI, -11.23, -2.54; P = 0.003), total cholesterol (beta -18.13 mg/dL; 95% CI, -23.42, -2.83; P = 0.02) and high sensitivity C-reactive protein (beta -1043.28 ng/mL; 95% CI, -1929.67, -156.89; P = 0.02), and increased nitric oxide (beta 7.86 mu mol/L; 95% CI, 5.63,10.09; P < 0.001), total antioxidant capacity (beta 119.30 mmol/L; 95% CI, 63.04, 175.57; P < 0.001) and total glutathione (beta 154.16 mu mol/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. (C) 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.