Title : Effect analysis of compound intestinal microecological preparation combined with limited energy and low carbon diet on the targeted regulation of body fat metabolism and intestinal barrier function in obese patients
[Aim] To investigate the effects of a compound intestinal microecological preparation supplemented with probiotics + prebiotics + metabolites of intestinal flora combined with a low carbon diet on the targeted regulation of body fat metabolism and intestinal barrier function in patients with simple obesity and to analyze the possible mechanism.[Methodology] From August 2017 to May 2019, 66 overweight adult or obese patients were admitted to the health management center of the department of nutrition, Shenzhen Hospital of Southern Medical University and according to the principle of voluntary randomization, they were divided into group A (N=23): accept compound intestinal microecology preparation + limit energy low carbon diet method to reduce weight. Group B (N=23): accepted the diet with limited energy and low carbon; Group C (N=20): obesity control group with balanced diet; At the same time, volunteers were recruited from healthy people for the control group with a balanced diet (group D,N=20 cases). To observe and compare between groups before and after the intervention for 3 months of BMI (Body Mass Index, BMI), Waist-hip ratio, fat content, lipids, incidence and severity of fatty liver, and At the same time, the changes of intestinal barrier function indexes such as d-lactic acid (intestinal mucosal permeability) bacterial lipopolysaccharide (LPS)(bacterial translocation) diamine oxidase (markers of intestinal mucosal damage) before and after intervention were monitored and the differences were compared. [Results] Before intervention, diamine oxidase (A marker of intestinal mucosa injury) in group A, B and C was significantly lower than that in the normal control group (group D)(P<0.01 or P<0.05). Diurnal bmi waist-to-hip ratio body fat mass associated with triglyceride (TG), cholesterol (TC), low density lipoprotein cholesterol (LDLc) and so on blood lipid metabolism index and degree of different incidence of fatty liver and serum D - lactic acid (intestinal mucosal permeability markers) bacteria lipopolysaccharide (LPS) (bacterial translocation markers) were significantly higher than that of group D (P < 0.01 or P < 0.05), but there was no significant difference comparison between ABC three groups (P > 0.05). With weight control intervention after 3 months: A, B two group of bmi waist-to-hip than body fat mass associated with triglyceride (TG), cholesterol (TC), low density lipoprotein cholesterol (LDLc) and so on blood lipid metabolism index and the severity of the incidence of fatty liver and fatty liver serum D - lactic acid (intestinal mucosal permeability) bacteria lipopolysaccharide (LPS) (bacterial translocation), and other indexes show varying degrees of decline, however, diamine oxidase (a marker of intestinal mucosal injury) showed an increasing trend to different degrees, but there was still a significant difference between the two groups (P<0.01 or P<0.05). After intervention, the body mass index of group A (a-c= -2.100 after t,p=0.045), waist-hip ratio of group A and group B, the incidence and severity of fatty liver and intestinal barrier function of group A were significantly decreased or significantly improved, and were significantly lower than that of group c. After the intervention group A lipid body fat mass associated with fatty liver and intestinal barrier function of change is more obvious, the indicators have significant difference compared with group B (P < 0.01 or P < 0.05) and after the intervention group A body fat mass has fallen to levels close to normal control group and D group was no significant difference (t after A - D = 1.566, P = 0.134) after the intervention group C and group D the indicators have A downward trend, but there was no significant difference before and after intervention (P > 0.05). [Conclusion] Obese patients all have intestinal mucosal injury to a certain extent, increased intestinal mucosal barrier permeability, positive serum LPS and other phenomena, which may be caused by the unreasonable diet structure leading to intestinal barrier function damage as one of the pathogenesis of inducing low-level inflammatory response. Compared with the simple low-carbon diet, the compound intestinal microecological preparation combined with low-carbon diet can reduce body fat and body mass index (bmi) TG to improve the severity of fatty liver, especially repair intestinal mucosal injury, reduce the permeability of intestinal mucosal barrier, and inhibit the transmigration of LPS to the blood. The mechanism may be to stimulate the regulation of fat catabolism in patients with simple obesity by improving the function of intestinal barrier. Further research on its mechanism will provide more basis and ideas for precise nutritional treatment of obesity.