# Effects of probiotics on blood lipids, glucose and pressure in patients with coronary heart disease: a systematic review and meta-analysis

## TL;DR

This study finds that probiotics can lower LDL cholesterol and insulin in coronary heart disease patients, but effects on other factors are unclear.

## Contribution

The study provides a meta-analysis of probiotic effects on blood lipids and glucose in coronary heart disease patients.

## Key findings

- Probiotics significantly reduced LDL-C and insulin levels in CHD patients.
- No significant effects were observed on blood pressure or triglycerides.
- Trial sequential analysis confirmed sufficient evidence for LDL-C and insulin.

## Abstract

This study aims to investigate the effects of probiotic supplementation on blood glucose, lipids and pressure in patients with coronary heart disease (CHD) through systematic review and meta-analysis, combined with sequential trial analysis, and to assess its safety.

A systematic search was conducted across five English-language databases: PubMed, Embase, Cochrane Library, Web of Science, and MEDLINE. The search period spanned from the inception of each database to May 31, 2,025. The baseline characteristics and data from the included studies were extracted and analyzed. Meta-analysis and trial sequential analysis (TSA) were performed using RevMan 5.3 and TSA 0.9.5.10 beta, respectively.

A total of nine studies involving 478 patients were included in this meta-analysis. The pooled results demonstrated that, compared with the placebo group, probiotic supplementation significantly reduced levels of low-density lipoprotein cholesterol (LDL-C) [mean difference [MD] −11.16, 95% confidence interval [CI] −18.82 to −3.50, P = 0.004], total cholesterol (TC) (MD −9.32, 95% CI −18.01 to −0.63, P = 0.04), fasting blood glucose (FBG) (MD −7.82, 95% CI −15.60 to −0.04, P = 0.05), and insulin (MD −2.47, 95% CI −4.16 to −0.78, P = 0.004), and increased high-density lipoprotein cholesterol (HDL-C) levels (MD 2.24, 95% CI 0.61 to 3.87, P = 0.007). No significant effects were observed on very-low-density lipoprotein cholesterol (VLDL-C) (MD −2.89, 95% CI −6.83 to 1.05, P = 0.15), triglyceride (TG) (MD −13.45, 95% CI −28.60 to 1.70, P = 0.08), homeostasis model assessment of insulin resistance (HOMA-IR) (MD −0.43, 95% CI −1.13 to 0.28, P = 0.23), QUICK (MD 0.00, 95% CI −0.00 to 0.01, P = 0.25), systolic blood pressure (SBP) (MD −1.99, 95% CI −4.97 to 1.00, P = 0.19), diastolic blood pressure (DBP) (MD −1.23, 95% CI −3.32 to 0.86, P = 0.25), or the incidence of adverse events (MD 2.00, 95% CI 0.20 to 20.49, P = 0.56). Trial sequential analysis confirmed that the evidence for LDL-C and insulin was sufficient to reach firm conclusions.

Probiotics have been shown to significantly reduce LDL-C and insulin levels in patients with CHD without increasing the risk of adverse events. However, the impact of probiotics on other metabolic parameters such as TC, FBG, and HDL-C remains inconclusive and requires further investigation through well-designed studies.

https://www.crd.york.ac.uk/PROSPERO/ PROSPERO CRD420251272111.