Efeito de probióticos sobre parâmetros antropométricos de indivíduos submetidos à revascularização miocárdica: um ensaio clínico randomizado, placebo-controlado e triplo cego

Abstract

Acute myocardial infarction (AMI) is one of the main serious adverse cardiovascular events related to coronary artery disease (CAD). The modulation of the intestinal microbiota by probiotics has been investigated as an adjuvant therapy in individuals with high cardiovascular risk, such as obesity, diabetes mellitus and dyslipidemia. However, there is a lack of studies evaluating the effect of probiotics after cardiovascular events, aiming at secondary prevention. Therefore, the objective of this randomized, controlled and triple-blind clinical trial was to evaluate the effect of probiotic supplementation on anthropometric parameters in individuals undergoing myocardial revascularization. Adult and elderly subjects undergoing coronary artery bypass graft surgery were randomized into two groups: control (placebo) and probiotic. The control group received 1 gram/day of maltodextrin and the probiotic group received 1 gram/day of probiotics, containing: Lactobacillus paracasei LBC81, Bifidobacterium lactis Bb12, Streptococcus thermophilus ATCC 19258 and Saccharomyces boulardii (1x109 per strain) during the period of 90 days. The primary outcome was a reduction in waist circumference (WC). Secondary outcomes were changes in measurements of weight, body mass index (BMI), arm circumference (AC) and arm muscle (AMC), arm muscle area (AMB), biceps (BCD), triceps (TCD), subscapularis (SEDC) and suprailiac (SICD), estimation of the percentage of body fat (%BF) and fat free mass (FFM), in addition to the thickness of the adductor pollicis muscle (EMAP). The randomization sequence was generated by a computer program, and allocation concealment was performed using sequential numerical codes generated from a table of random numbers. Analyzes of covariance were performed to compare differences between groups regarding research outcomes. The level of statistical significance adopted was 5%. A total of 36 participants were randomized to the intervention group (n=18) and placebo (n=18) and completed the research protocol. After 30 days of supplementation, the probiotic group showed a statistically significant decrease in BMI values (p = 0.048; mean difference of 2.6 kg/m²), BCD (p = 0.026; mean difference of 3.2 mm), TCD ( p = 0.002; mean difference of 4.5 mm), %BF (p<0.001; mean difference of 3.6%) and FFM (p = 0.018; mean difference of 1.1%), when compared to the placebo group. After 90 days of supplementation, statistically significant reductions were still present in the probiotic group in relation to the values of BCD (p = 0.049; mean difference of 3.1 mm), TCD (p < 0.001; mean difference of 4.6 mm), %BF (p< 0.001; mean difference of 3.3%) and FFM (p = 0.004; mean difference of 1.0%) when compared to placebo. In conclusion, probiotic supplementation for 90 days in individuals who underwent coronary artery bypass graft surgery significantly decreased anthropometric parameters, especially those related to body adiposity.