Synbiotics in Metabolic Health: Transforming Therapy for Obesity, Diabetes, and Dyslipidemia

Authors:

1. Dr. Neeraj Mishra, Professor, Amity Institute of Pharmacy, Amity University Madhya Pradesh (Corresponding author)

2. Devyani Rajput, Assistant Professor, Amity Institute of Pharmacy, Amity University Madhya Pradesh

Synbiotics, combining probiotics and prebiotics, are promising in metabolic disorder management by modulating gut microbiota, enhancing bioavailability, and supporting metabolic health. They optimise gut composition, improve glucose homeostasis, reduce inflammation, and positively influence lipid profiles, offering a potential adjunct therapy for conditions like obesity, diabetes, and dyslipidemia.

1. Introduction

Metabolic disorders have become a widespread epidemic globally, posing one of the most significant public health challenges of the twenty-first century. The incidence rate ranges between 20 to 45 percent (Ramesh et al., 2023). The World Health Organization (WHO) projects that by 2025, around 300 million individuals worldwide will develop metabolic disorders along with their associated complications (van Hoogstraten et al., 2023). The primary metabolic disorders observed are complex conditions characterised by interconnected metabolic abnormalities such as obesity, hyperlipidemia, inflammation, and nonalcoholic fatty liver disease, as shown in Fig. 1. Numerous lifestyle and dietary elements contribute to these issues. Given the growing health concerns, it is crucial to seek effective strategies for prevention and treatment (Sharma et al., 2024). One preventive strategy that has emerged to combat increasing healthcare expenses is the development of innovative synbiotic products. Synbiotics involve the combined effects of probiotics and prebiotics, which offer various therapeutic advantages and have been utilised for the prevention and treatment of human illnesses over the last decade (Kaushik et al.; Pandey et al., 2015).

Elevated blood glucose levels and insulin resistance (IR) are critical concerns in patients with metabolic disorders, potentially leading to cardiovascular diseases (CVDs) and type 2 diabetic mellitus (T2DM) if left uncontrolled and untreated (Zhao et al., 2023). Moreover, a significant and robust correlation exists between metabolic problems and nonalcoholic fatty liver disease (NAFLD). When combined with elevated plasma low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC), lipid abnormalities—which include elevated triglycerides and decreased HDL-C—define metabolic abnormalities that significantly lead to the development of cardiovascular diseases (CVDs) (Højlund, 2014; Muzurović et al., 2021).

Fig 1: Mechanisms of synbiotics on metabolic diseases targeting gut microbiota.

Synbiotics, which are prebiotic foods mixed with probiotic strains, can have a major effect on metabolic activities. Current research identifies three primary pathways via which synbiotics affect metabolic diseases: alterations in gut microbiota composition, modification of gut microbial metabolites, and augmentation of intestinal barrier function; these will be elaborated upon subsequently (Oniszczuk et al., 2021; Santos-Marcos et al., 2019).

2.1 By modulation of Gut Microbiota Composition

Synbiotics have been recognised as a viable approach for obesity prevention. The amalgamation of omega-3 fatty acids and live probiotics, including Bifidobacterium, Lactobacillus, Lactococcus, and Propionibacterium, has demonstrated superior efficacy in diminishing liver fat and lipid buildup compared to the usage of probiotics in isolation (Yang et al., 2024). Additionally, oral supplements containing xylo-oligosaccharides and Bacillus licheniformis have shown enhanced weight management and lipid metabolism in obese rats, as well as a decrease in the populations of Desulfovibrionaceae and Ruminococcaceae (Li et al., 2021). The combination of Lactobacillus plantarum PMO 08 and chia seeds in murine models has demonstrated a synergistic effect on adiposity, thereby improving the intestinal environment that is conducive to the proliferation of Lactobacillus plantarum (Pires et al., 2024). Alterations in gut microbial composition were associated with increased activation of the IRS1-Akt-GLUT2 and SIRT1-AMPK-PPARα-CPR1α signaling pathways, as well as decreased ACE mRNA, bile salt hydrolase activity, and hepatic cholesterol 7-alpha hydroxylase expression (Li et al., 2021).

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