Recent research from a randomised controlled trial (RCT) suggests that probiotics can help regulate cholesterol levels by optimizing the gut microbiome, particularly in people taking statins.
Study Overview
Researchers in China conducted a randomised, double-blind, placebo-controlled clinical trial to evaluate the role of probiotics in treating hyperlipidaemia (high cholesterol). They found that probiotics improved gut microbiota structure and reduced harmful bacteria in patients. When combined with atorvastatin, a commonly prescribed statin, probiotics showed additional benefits for patients.
“Probiotics can influence the composition of gut microorganisms and increase their diversity and abundance in vivo. It is recommended to use probiotics combined with atorvastatin to treat patients with hyperlipidaemia,” the researchers wrote in Medicine.
Hyperlipidaemia is characterised by high levels of triglycerides or lipids (fats) in the blood, a risk factor for arteriosclerosis and cardiovascular disease. It includes high total cholesterol (TC), high LDL-C (low-density lipoprotein cholesterol), high triglycerides (TG), and low HDL-C (high-density lipoprotein cholesterol).
Clinical Findings
Clinical studies confirm that gut imbalance in hyperlipidaemia patients is mainly seen as a decrease in beneficial bacteria like Lactobacillus and Bifidobacterium and an increase in harmful bacteria like Bacteroides and Enterococcus. Both human and animal studies indicate that probiotics can reduce TC, TG, and LDL-C levels while improving gut microecological balance.
The study used compound probiotics consisting of Lactobacillus casei Zhang, Bifidobacterium animalis subsp. lactis V9, and Lactobacillus plantarum P-8. The researchers aimed to observe how these probiotics alter gut microbiota and explore the relationship between intestinal flora and blood lipid changes.
Trial Design and Results
The trial took place at the Inner Mongolia People’s Hospital from January to December 2019, involving 33 hyperlipidaemia patients aged 45 to 66. Participants were randomly divided into a probiotic group and a control group. The probiotic group received compound probiotics (2 g once daily) and atorvastatin 20 mg (once daily), while the control group received a placebo and atorvastatin.
Physical examinations, including height, weight, waist circumference, blood pressure, and plasma lipid levels, were conducted monthly. Serum and fecal samples were also analyzed.
Results showed that the probiotic group had higher gut microbial abundance than the control group after three months. Significant differences in gut microbiome composition were observed between the two groups, indicating that probiotics enhance gut microbe diversity and abundance.
“Both the control and probiotic groups showed downregulated TC, TG, and LDL-C at months 1, 2, and 3 in contrast to month 0,” noted the researchers. “Probiotics can optimize gut microbiota composition and reduce harmful bacteria in hyperlipidaemia patients.”
The study revealed significant changes at the phylum level, with probiotics reducing Proteobacteria and increasing Tenericutes. Although Firmicutes, Bacteroidetes, and Actinobacteria showed no notable differences, Tenericutes contributed to gut microbiome diversity.
At the genus level, probiotics increased the abundance of beneficial bacteria such as Bifidobacterium, Lactobacillus, and Akkermansia, and decreased harmful bacteria like Escherichia, Eggerthella, and Sutterella. This suggests that probiotics help lower fat accumulation and reduce cholesterol levels.
Conclusion
Probiotics show promise for treating hyperlipidaemia by enhancing gut microbiota composition and diversity. Researchers recommend combining probiotics with atorvastatin for patients with hyperlipidaemia.
“In conclusion, probiotics have good application prospects for the treatment of hyperlipidaemia. However, further long-term animal experiments and large-sample, multi-centre clinical trials are needed to standardise and confirm the efficacy of probiotics in clinical applications,” the researchers stated.
