Combined therapy for intestinal dysbiosis as a strategy for the treatment of lipid metabolism disorders

  • Received 23.08.2025
  • Revised 01.12.2025
  • Accepted 30.12.2025
  • Published 06.01.2026
  • 319 Views
  • Retrieved from Vol. 11, No. 2, 2025
  • Pages 26-33

Dyslipidaemia, a major contributor to cardiovascular diseases, necessitates multifaceted treatment strategies. This study aimed to evaluate the effectiveness of combined therapy – including probiotics, lifestyle modifications, and dietary recommendations – in managing dyslipidaemia and its impact on gut microbiota composition. A total of 168 patients with dyslipidaemia were enrolled and categorised according to cardiovascular risk using the SCORE scale. Group  1 included low-risk patients, while Group  2 comprised moderate-risk patients who also received simvastatin. Both groups were prescribed a 12-week probiotic regimen containing Lactobacillus acidophilus LA-5 and Bifidobacterium lactis BB-12, alongside recommendations for physical activity and cholesterollowering diets. Comprehensive assessments of lipid profiles and gut microbiota composition were conducted before and after treatment. The results demonstrated significant improvements in lipid profiles in both groups. Total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels decreased, while high-density lipoprotein cholesterol levels increased. Statistical analysis showed that the differences in the percentage reductions of lipid profile parameters between the two groups were not statistically significant (p > 0.05), confirming the potential impact of probiotic therapy on lipid levels. Analysis of the gut microbiota revealed an increase in Bacteroidetes, and reductions in Firmicutes and Actinobacteria, along with a notable improvement in the Firmicutes/Bacteroidetes ratio, indicating restored microbial balance. This study highlighted the potential of probiotics as an effective adjunct in the management of dyslipidaemia, capable of complementing – or even reducing dependence on – statin therapy. The findings support the integration of microbiota-targeted therapies into personalised treatment strategies for dyslipidaemia

microbial composition; dyslipidaemia; probiotics; Bifidobacterium lactis BB-12; Lactobacillus acidophilus LA-5

https://doi.org/10.63341/ijmmr/2.2025.26
  1. Pavlidou E, Fasoulas A, Mantzorou M, Giaginis C. Clinical evidence on the potential beneficial effects of probiotics and prebiotics in cardiovascular disease. Int J Mol Sci. 2022;23(24):15898. DOI: 10.3390/ijms232415898
  2. Oniszczuk A, Oniszczuk T, Gancarz M, Szymańska J. Role of gut microbiota, probiotics and prebiotics in the cardiovascular diseases. Molecules. 2021;26(4):1172. DOI: 10.3390/molecules26041172
  3. Banach K, Glibowski P, Jedut P. The effect of probiotic yogurt containing Lactobacillus Acidophilus LA-5 and Bifidobacterium Lactis BB-12 on selected anthropometric parameters in obese individuals on an energy-restricted diet: A randomized, controlled trial. Appl. Sci. 2020;10(17):5830. DOI: 10.3390/app10175830
  4. Markowiak-Kopeć P, Śliżewska K. The effect of probiotics on the production of short-chain fatty acids by human intestinal microbiome. Nutrients. 2020;12(4):1107. DOI: 10.3390/nu12041107
  5. Palaniyandi SA, Damodharan K, Suh JW, Yang SH. Probiotic characterization of cholesterol-lowering Lactobacillus fermentum MJM60397. Probiotics Antimicrob Proteins. 2020;12(3):1161– 72. DOI: 10.1007/s12602-019-09585-y
  6. Khare A, Gaur S. Cholesterol-lowering effects of Lactobacillus species. Curr Microbiol. 2020;77(4):638–44. DOI: 10.1007/s00284-020-01903-w
  7. Nechiporuk VM, Nebesna ZM, Kovalchuk ОV, Pentiuk LO, Korda MM. Ultrastructural changes in the liver in experimental hyperhomocysteinemia on the background of hypo- and hyperthyroidism. Bull Med Biol Res. 2021;3(2):51–60. DOI: 10.11603/bmbr.2706-6290.2021.2.12339
  8. Wongrattanapipat S, Chiracharoenchitta A, Choowongwitthaya B, Komsathorn P, La-Ongkham O, Nitisinprasert S, et al. Selection of potential probiotics with cholesterol-lowering properties for probiotic yoghurt production. Food Sci Technol Int. 2022;28(4):353–65. DOI: 10.1177/10820132211012252
  9. Noori M, Shateri Z, Babajafari S, Eskandari MH, Parastouei K, Ghasemi M, et al. The effect of probiotic-fortified kefir on cardiovascular risk factors in elderly population: A double-blind, randomized, placebo-controlled clinical trial. BMC Nutr. 2024;10(1):74. DOI: 10.1186/s40795-024-00875-5
  10. The World Medical Association. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects [Internet]. [cited 2025 May 15]. Available from: https://www.wma.net/what-we-do/medical-ethics/declaration-of-helsinki/
  11. Council of Europe. Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine [Internet]. 1997 April 4 [cited 2025 May 15]. Available from: https://rm.coe.int/168007cf98
  12. Order of the Ministry of Health of Ukraine No. 690. On Approval of the Procedure for Conducting Clinical Trials of Medicinal Products and Expertise of Materials of Clinical Trials and the Model Regulation on Ethics Committees [Internet]. 2009 September 23 [cited 2025 May 15]. Available from: https://zakon.rada.gov.ua/laws/show/z1010-09#Text
  13. Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: The SCORE project. Eur Heart J. 2003;24(11):987–1003. DOI: 10.1016/s0195-668x(03)00114-3
  14. Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111–88. DOI: 10.1093/eurheartj/ehz455
  15. Mitchenko O, Lutai M. Recommendations for the diagnosis and treatment of dyslipidaemia. Kyiv: Ukrainian Association of Cardiologists of Ukraine; Ukrainian Society of Atherosclerosis; 2020. 46 P.
  16. Zhou S, Liu L, Ye B, Xu Y, You Y, Zhu S, et al. Gut microbial metabolism is linked to variations in circulating non-high density lipoprotein cholesterol. EBioMedicine. 2024;104:105150. DOI: 10.1016/j.ebiom.2024.105150
  17. Yan C, Bao J, Jin J. Exploring the interplay of gut microbiota, inflammation, and LDL-cholesterol: A multiomics Mendelian randomization analysis of their causal relationship in acute pancreatitis and non-alcoholic fatty liver disease. J Transl Med. 2024;22(1):179. DOI: 10.1186/s12967-024-04996-0
  18. Flaig B, Garza R, Singh B, Hamamah S, Covasa M. Treatment of dyslipidemia through targeted therapy of gut microbiota. Nutrients. 2023;15(1):228. DOI: 10.3390/nu15010228
  19. Canyelles M, Borràs C, Rotllan N, Tondo M, Escolà-Gil JC, Blanco-Vaca F. Gut microbiota-derived TMAO: A causal factor promoting atherosclerotic cardiovascular disease? Int J Mol Sci. 2023;24(3):1940. DOI: 10.3390/ijms24031940
  20. Brown EM, Clardy J, Xavier RJ. Gut microbiome lipid metabolism and its impact on host physiology. Cell Host Microbe. 2023;31(2):173–86. DOI: 10.1016/j.chom.2023.01.009
  21. Roessler J, Leistner DM, Landmesser U, Haghikia A. Modulatory role of gut microbiota in cholesterol and glucose metabolism: Potential implications for atherosclerotic cardiovascular disease. Atherosclerosis. 2022;359:1–12. DOI: 10.1016/j.atherosclerosis.2022.08.018
  22. Duan Y, Wang L, Ma Y, Ning L, Zhang X. A meta-analysis of the therapeutic effect of probiotic intervention in obese or overweight adolescents. Front Endocrinol. 2024;15:1335810. DOI: 10.3389/fendo.2024.1335810
  23. Kenny DJ, Plichta DR, Shungin D, Koppel N, Hall AB, Fu B, et al. Cholesterol metabolism by uncultured human gut bacteria influences host cholesterol level. Cell Host Microbe. 2020;28(2):245–57. DOI: 10.1016/j.chom.2020.05.013
  24. Lei L, Zhao N, Zhang L, Chen J, Liu X, Piao S. Gut microbiota is a potential goalkeeper of dyslipidemia. Front Endocrinol. 2022;13:950826. DOI: 10.3389/fendo.2022.950826
  25. Kappel BA, De Angelis L, Puetz A, Ballanti M, Menghini R, Marx N, et al. Antibiotic-induced gut microbiota depletion exacerbates host hypercholesterolemia. Pharmacol Res. 2023;187:106570. DOI: 10.1016/j.phrs.2022.106570