human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Although several studies have found probiotics encouraging in prevention of gestational diabetes mellitus ( GDM ) , the evidence for the use of probiotics in diagnosed GDM is largely limited . The aim of this study was to assess the effect of a probiotic supplement capsule containing four bacterial strains on glucose metabolism indices and weight changes in women with newly diagnosed GDM . Methods Sixty-four pregnant women with GDM were enrolled into a double-blind placebo-controlled r and omized clinical trial . They were r and omly assigned to receive either a probiotic or placebo capsule along with dietary advice for eight consecutive weeks . The trend of weight gain along with glucose metabolism indices was assayed . Results During the first 6 weeks of the study , the weight gain trend was similar between the groups . However , in the last 2 weeks of the study , the weight gain in the probiotic group was significantly lower than in the placebo group ( p < 0.05 ) . Fasting blood sugar ( FBS ) decreased in both intervention ( from 103.7 to 88.4 mg/dl ) and control ( from 100.9 to 93.6 mg/dl ) groups significantly , and the decrease in the probiotic group was significantly higher than in the placebo group ( p < 0.05 ) . Insulin resistance index in the probiotic group had 6.74 % reduction over the study period ( p < 0.05 ) . In the placebo group , however , there was an increase in insulin resistance index ( 6.45 % ) , but the observed change in insulin resistance was not statistically significant . Insulin sensitivity index was increased in both groups . The post-intervention insulin sensitivity index in the probiotic group was not significantly different from placebo when adjusted for the baseline levels . Conclusions The probiotic supplement appeared to affect glucose metabolism and weight gain among pregnant women with GDM . This needs to be confirmed in other setting s before a therapeutic value could be approved AIMS The role of gut microbiota in the management of diabetes is shown . In this r and omized clinical trial we assessed the effects of synbiotic supplementation on insulin , lipid profile and antioxidative status among women with gestational diabetes mellitus ( GDM ) . METHODS Ninety pregnant women with GDM were r and omly assigned into two groups to receive either a daily synbiotic capsule - consisting of L. acidophilus , L. plantarum , L. fermentum , L. gasseri ( 1.5 - 7.0 × 109 - 10 CFU/g ) - with fructooligosaccharide ( 38.5 mg ) , or placebo for 6 weeks . Fasting plasma glucose ( FPG ) , insulin , homeostasis model assessment -insulin resistance ( HOMA-IR ) , quantitative insulin sensitivity check index ( QUICKI ) , high- and low density lipoprotein cholesterol ( HDL-C , LDL-C ) , total cholesterol ( TC ) , triglycerides ( TG ) , total antioxidant capacity ( TAC ) , and systolic and diastolic blood pressure ( SBP , DSP ) were assessed before and after the intervention . RESULTS No significant changes in FPG , insulin resistance/sensitivity , lipid profile and TAC indices were seen in synbiotic group compared to the placebo one ( p > 0.05 ) . Significant within group increases for HDL-C and TAC levels in synbiotic group were observed ( p < 0.05 ) . LDL-C showed significant increment in the placebo group compared to the baseline of the study ( 6.9 mg/dL , p < 0.05 ) . Between group comparison showed significant decrease in SBP and DBP in synbiotic group compared to placebo ( -2.5 vs. 8.6 mmHg , and -1.8 vs. 2.1 mmHg , p < 0.05 ) . CONCLUSIONS The results showed that , in women with GDM , synbiotic supplementation had no effect on FPG and insulin resistance/sensitivity indices . Lipid profile and TAC status may be affected by synbiotic supplementation . Synbiotic is effective in reducing of blood pressure in women with GDM Abstract Synbiotics are known to exert multiple beneficial effects , including anti-inflammatory and antioxidative actions . This study was design ed to evaluate the effects of synbiotic administration on biomarkers of inflammation , oxidative stress , and pregnancy outcomes among gestational diabetic ( GDM ) women . This r and omized , double-blind , placebo-controlled clinical trial was carried out among 60 subjects with GDM who were not on oral hypoglycemic agents . Patients were r and omly assigned to consume either one synbiotic capsule containing Lactobacillus acidophilus strain T16 ( IBRC-M10785 ) , L. casei strain T2 ( IBRC-M10783 ) , and Bifidobacterium bifidum strain T1 ( IBRC-M10771 ) ( 2 × 109 CFU/g each ) plus 800 mg inulin ( HPX ) ( n = 30 ) or placebo ( n = 30 ) for 6 weeks . Compared with the placebo , synbiotic supplementation significantly decreased serum high-sensitivity C-reactive protein ( hs-CRP ) ( − 1.9 ± 4.2 vs. + 1.1 ± 3.5 mg/L , P = 0.004 ) , plasma malondialdehyde ( MDA ) ( − 0.1 ± 0.6 vs. + 0.3 ± 0.7 μmol/L , P = 0.02 ) , and significantly increased total antioxidant capacity ( TAC ) ( + 70.1 ± 130.9 vs. − 19.7 ± 124.6 mmol/L , P = 0.009 ) and total glutathione ( GSH ) levels ( + 28.7 ± 61.5 vs. − 14.9 ± 85.3 μmol/L , P = 0.02 ) . Supplementation with synbiotic had a significant decrease in cesarean section rate ( 16.7 vs. 40.0 % , P = 0.04 ) , lower incidence of hyperbilirubinemic newborns ( 3.3 vs. 30.0 % , P = 0.006 ) , and newborns ’ hospitalization ( 3.3 vs. 30.0 % , P = 0.006 ) compared with the placebo . Synbiotic supplementation did not affect plasma nitric oxide ( NO ) levels and other pregnancy outcomes . Overall , synbiotic supplementation among GDM women for 6 weeks had beneficial effects on serum hs-CRP , plasma TAC , GSH , and MDA ; cesarean section ; incidence of newborn ’s hyperbilirubinemia ; and newborns ’ hospitalization but did not affect plasma NO levels and other pregnancy outcomes . http://www.i rct .ir : www.i rct .ir : I RCT Whether the incidence of coronary heart disease ( CHD ) is related to a decrease in total antioxidant capacity ( TAC ) has not yet been completely clarified . We assessed  TAC  of blood serum in a group of 163 men with CHD aged 34.8–77.0 years and in 163 age-matched peers without CHD .  Two spectrophotometric methods were applied to assess  TAC : ferric reducing ability of serum ( TAC-FRAS ) and 2.2-diphenyl-1-picryl-hydrazyl ( TAC-DPPH ) tests .  In the CHD group , multivariate analysis revealed that uric acid ( UA ) , triglycerides , and systolic blood pressure contributed independently to the TAC-FRAS variance .  TAC-DPPH  was favorably predicted by UA concentration , but negatively so by current smoking and glucose levels . In men without CHD , UA was the only independent determinant of both TAC-FRAS and TAC-DPPH . Presence of CHD was not an independent predictor of TAC — observed between-group differences ( higher TAC in CHD patients ) disappeared after adjustment for other confounders . We conclude that UA is the main determinant of TAC of blood serum in men .  TAC is not directly influenced by age or CHD but is related to several indices of overweight/obesity and laboratory measures of metabolic syndrome , especially in patients with CHD Abstract Objective : To prospect ively evaluate maternal and cord blood concentrations of sclerostin – an osteocyte-secreted factor , inhibiting osteoblast differentiation and bone formation and associated with adverse metabolism – in pregnancies with normal and abnormal fetal growth . Methods : Plasma sclerostin concentrations were determined by ELISA in 80 maternal and 80 cord blood sample s from asymmetric intrauterine-growth-restricted ( IUGR , n = 30 ) , large-for-gestational-age ( LGA , n = 30 ) , and appropriate-for-gestational-age ( AGA , n = 20 ) singleton full-term pregnancies . Fourteen out of 30 mothers with LGA offspring presented with gestational diabetes mellitus ( GDM ) . Results : Maternal and fetal sclerostin concentrations did not differ among LGA , IUGR , and AGA groups . Fetal concentrations were higher than maternal . In LGA group , maternal concentrations were elevated in cases of GDM ( b = 13.009 , 95%CI 1.425–24.593 , p = .029 ) . In a combined group and the IUGR  group , maternal concentrations were elevated in older mothers ( b = 0.788 , 95%CI 0.190–1.385 , p = .010 , and b = 0.740 , 95%CI 0.042–1.438 , p = .039 , respectively ) . Conclusions : Maternal and fetal sclerostin concentrations may not be differentially regulated in pregnancies complicated by abnormal fetal growth . Circulating maternal levels are higher in cases of GDM , probably implying reduced bone formation . Sclerostin up-regulation with aging may be one of the molecular pathways responsible for the observed age-related decline in bone synthesis , leading to accelerated bone loss in humans Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background Low grade chronic inflammation is observed in patients with type 2 diabetes mellitus ( T2DM ) . Endotoxin derived from gut bacteria may act as a potent inflammatory stimulant . Probiotics , which are believed to contain health promoting live microorganisms , may influence circulating endotoxin levels . Ingestion of live probiotic cultures may alter gut microbiota in a beneficial manner to reduce inflammation ; no information is available whether or not they do so in patients with T2DM . Therefore , the aim of this study is to characterize the beneficial effects of probiotics on circulating endotoxin levels and other biomarkers related to systemic low- grade inflammation in patients with T2DM . Methods One hundred and twenty consenting adult Saudi T2DM patients ( naïve or newly diagnosed and without co-morbidities ) will be enrolled in this clinical trial and r and omized to receive daily placebo or probiotics ( Ecologic ® Barrier ) for 26 weeks in a double-blind manner . Inflammatory and metabolic markers will be measured and fecal sample s analyzed . Measurements / sample s will be obtained at baseline and after 4 , 8 , 12/13 and 26 weeks of treatment . Discussion It is expected that the probiotic product will induce beneficial changes in gut microbiota , reduce the systemic inflammatory state through altering systemic endotoxin levels and , as such , reduce the systemic inflammatory response observed in T2DM subjects . Trial registration Clinical Trials.gov Identifier : Objective . This trial aims to examine the effects of a Probiotic Mixture ( VSL#3 ) on glycemic status and inflammatory markers , in women with GDM . Material s and Methods . Over a period of 8 weeks , 82 women with gestational diabetes were r and omly assigned to either an intervention group ( n = 41 ) which were given VSL#3 capsule or to a control group which were given placebo capsule ( n = 41 ) . Fasting plasma glucose , homeostatic model assessment of insulin resistance , glycosylated hemoglobin , high-sensitivity C-reactive protein , tumor necrosis factor-α , interleukin-6 , Interferon gamma , and interleukin-10 were measured before and after the intervention . Results . After 8 wk of supplementation FPG , HbA1c , HOMA-IR , and insulin levels remained unchanged in the probiotic and placebo groups . The comparison between the two groups showed no significant differences with FPG and HbA1c , but there were significant differences in insulin levels and HOMA-IR ( 16.6 ± 5.9 ; 3.7 ± 1.5 , resp . ) . Unlike the levels of IFN-g ( 19.21 ± 16.6 ) , there was a significant decrease in levels of IL-6 ( 3.81 ± 0.7 ) , TNF-α ( 3.10 ± 1.1 ) , and hs-CRP ( 4927.4 ± 924.6 ) . No significant 
    Output:
    
agent
Conclusion Probiotic supplementation seemed to be able to reduce the risk of a newborn 's hyperbilirubinemia and improve glycemic control , blood lipid profiles and inflammation and oxidative stress in pregnant women with GDM .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Although several studies have found probiotics encouraging in prevention of gestational diabetes mellitus ( GDM ) , the evidence for the use of probiotics in diagnosed GDM is largely limited . The aim of this study was to assess the effect of a probiotic supplement capsule containing four bacterial strains on glucose metabolism indices and weight changes in women with newly diagnosed GDM . Methods Sixty-four pregnant women with GDM were enrolled into a double-blind placebo-controlled r and omized clinical trial . They were r and omly assigned to receive either a probiotic or placebo capsule along with dietary advice for eight consecutive weeks . The trend of weight gain along with glucose metabolism indices was assayed . Results During the first 6 weeks of the study , the weight gain trend was similar between the groups . However , in the last 2 weeks of the study , the weight gain in the probiotic group was significantly lower than in the placebo group ( p < 0.05 ) . Fasting blood sugar ( FBS ) decreased in both intervention ( from 103.7 to 88.4 mg/dl ) and control ( from 100.9 to 93.6 mg/dl ) groups significantly , and the decrease in the probiotic group was significantly higher than in the placebo group ( p < 0.05 ) . Insulin resistance index in the probiotic group had 6.74 % reduction over the study period ( p < 0.05 ) . In the placebo group , however , there was an increase in insulin resistance index ( 6.45 % ) , but the observed change in insulin resistance was not statistically significant . Insulin sensitivity index was increased in both groups . The post-intervention insulin sensitivity index in the probiotic group was not significantly different from placebo when adjusted for the baseline levels . Conclusions The probiotic supplement appeared to affect glucose metabolism and weight gain among pregnant women with GDM . This needs to be confirmed in other setting s before a therapeutic value could be approved AIMS The role of gut microbiota in the management of diabetes is shown . In this r and omized clinical trial we assessed the effects of synbiotic supplementation on insulin , lipid profile and antioxidative status among women with gestational diabetes mellitus ( GDM ) . METHODS Ninety pregnant women with GDM were r and omly assigned into two groups to receive either a daily synbiotic capsule - consisting of L. acidophilus , L. plantarum , L. fermentum , L. gasseri ( 1.5 - 7.0 × 109 - 10 CFU/g ) - with fructooligosaccharide ( 38.5 mg ) , or placebo for 6 weeks . Fasting plasma glucose ( FPG ) , insulin , homeostasis model assessment -insulin resistance ( HOMA-IR ) , quantitative insulin sensitivity check index ( QUICKI ) , high- and low density lipoprotein cholesterol ( HDL-C , LDL-C ) , total cholesterol ( TC ) , triglycerides ( TG ) , total antioxidant capacity ( TAC ) , and systolic and diastolic blood pressure ( SBP , DSP ) were assessed before and after the intervention . RESULTS No significant changes in FPG , insulin resistance/sensitivity , lipid profile and TAC indices were seen in synbiotic group compared to the placebo one ( p > 0.05 ) . Significant within group increases for HDL-C and TAC levels in synbiotic group were observed ( p < 0.05 ) . LDL-C showed significant increment in the placebo group compared to the baseline of the study ( 6.9 mg/dL , p < 0.05 ) . Between group comparison showed significant decrease in SBP and DBP in synbiotic group compared to placebo ( -2.5 vs. 8.6 mmHg , and -1.8 vs. 2.1 mmHg , p < 0.05 ) . CONCLUSIONS The results showed that , in women with GDM , synbiotic supplementation had no effect on FPG and insulin resistance/sensitivity indices . Lipid profile and TAC status may be affected by synbiotic supplementation . Synbiotic is effective in reducing of blood pressure in women with GDM Abstract Synbiotics are known to exert multiple beneficial effects , including anti-inflammatory and antioxidative actions . This study was design ed to evaluate the effects of synbiotic administration on biomarkers of inflammation , oxidative stress , and pregnancy outcomes among gestational diabetic ( GDM ) women . This r and omized , double-blind , placebo-controlled clinical trial was carried out among 60 subjects with GDM who were not on oral hypoglycemic agents . Patients were r and omly assigned to consume either one synbiotic capsule containing Lactobacillus acidophilus strain T16 ( IBRC-M10785 ) , L. casei strain T2 ( IBRC-M10783 ) , and Bifidobacterium bifidum strain T1 ( IBRC-M10771 ) ( 2 × 109 CFU/g each ) plus 800 mg inulin ( HPX ) ( n = 30 ) or placebo ( n = 30 ) for 6 weeks . Compared with the placebo , synbiotic supplementation significantly decreased serum high-sensitivity C-reactive protein ( hs-CRP ) ( − 1.9 ± 4.2 vs. + 1.1 ± 3.5 mg/L , P = 0.004 ) , plasma malondialdehyde ( MDA ) ( − 0.1 ± 0.6 vs. + 0.3 ± 0.7 μmol/L , P = 0.02 ) , and significantly increased total antioxidant capacity ( TAC ) ( + 70.1 ± 130.9 vs. − 19.7 ± 124.6 mmol/L , P = 0.009 ) and total glutathione ( GSH ) levels ( + 28.7 ± 61.5 vs. − 14.9 ± 85.3 μmol/L , P = 0.02 ) . Supplementation with synbiotic had a significant decrease in cesarean section rate ( 16.7 vs. 40.0 % , P = 0.04 ) , lower incidence of hyperbilirubinemic newborns ( 3.3 vs. 30.0 % , P = 0.006 ) , and newborns ’ hospitalization ( 3.3 vs. 30.0 % , P = 0.006 ) compared with the placebo . Synbiotic supplementation did not affect plasma nitric oxide ( NO ) levels and other pregnancy outcomes . Overall , synbiotic supplementation among GDM women for 6 weeks had beneficial effects on serum hs-CRP , plasma TAC , GSH , and MDA ; cesarean section ; incidence of newborn ’s hyperbilirubinemia ; and newborns ’ hospitalization but did not affect plasma NO levels and other pregnancy outcomes . http://www.i rct .ir : www.i rct .ir : I RCT Whether the incidence of coronary heart disease ( CHD ) is related to a decrease in total antioxidant capacity ( TAC ) has not yet been completely clarified . We assessed  TAC  of blood serum in a group of 163 men with CHD aged 34.8–77.0 years and in 163 age-matched peers without CHD .  Two spectrophotometric methods were applied to assess  TAC : ferric reducing ability of serum ( TAC-FRAS ) and 2.2-diphenyl-1-picryl-hydrazyl ( TAC-DPPH ) tests .  In the CHD group , multivariate analysis revealed that uric acid ( UA ) , triglycerides , and systolic blood pressure contributed independently to the TAC-FRAS variance .  TAC-DPPH  was favorably predicted by UA concentration , but negatively so by current smoking and glucose levels . In men without CHD , UA was the only independent determinant of both TAC-FRAS and TAC-DPPH . Presence of CHD was not an independent predictor of TAC — observed between-group differences ( higher TAC in CHD patients ) disappeared after adjustment for other confounders . We conclude that UA is the main determinant of TAC of blood serum in men .  TAC is not directly influenced by age or CHD but is related to several indices of overweight/obesity and laboratory measures of metabolic syndrome , especially in patients with CHD Abstract Objective : To prospect ively evaluate maternal and cord blood concentrations of sclerostin – an osteocyte-secreted factor , inhibiting osteoblast differentiation and bone formation and associated with adverse metabolism – in pregnancies with normal and abnormal fetal growth . Methods : Plasma sclerostin concentrations were determined by ELISA in 80 maternal and 80 cord blood sample s from asymmetric intrauterine-growth-restricted ( IUGR , n = 30 ) , large-for-gestational-age ( LGA , n = 30 ) , and appropriate-for-gestational-age ( AGA , n = 20 ) singleton full-term pregnancies . Fourteen out of 30 mothers with LGA offspring presented with gestational diabetes mellitus ( GDM ) . Results : Maternal and fetal sclerostin concentrations did not differ among LGA , IUGR , and AGA groups . Fetal concentrations were higher than maternal . In LGA group , maternal concentrations were elevated in cases of GDM ( b = 13.009 , 95%CI 1.425–24.593 , p = .029 ) . In a combined group and the IUGR  group , maternal concentrations were elevated in older mothers ( b = 0.788 , 95%CI 0.190–1.385 , p = .010 , and b = 0.740 , 95%CI 0.042–1.438 , p = .039 , respectively ) . Conclusions : Maternal and fetal sclerostin concentrations may not be differentially regulated in pregnancies complicated by abnormal fetal growth . Circulating maternal levels are higher in cases of GDM , probably implying reduced bone formation . Sclerostin up-regulation with aging may be one of the molecular pathways responsible for the observed age-related decline in bone synthesis , leading to accelerated bone loss in humans Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background Low grade chronic inflammation is observed in patients with type 2 diabetes mellitus ( T2DM ) . Endotoxin derived from gut bacteria may act as a potent inflammatory stimulant . Probiotics , which are believed to contain health promoting live microorganisms , may influence circulating endotoxin levels . Ingestion of live probiotic cultures may alter gut microbiota in a beneficial manner to reduce inflammation ; no information is available whether or not they do so in patients with T2DM . Therefore , the aim of this study is to characterize the beneficial effects of probiotics on circulating endotoxin levels and other biomarkers related to systemic low- grade inflammation in patients with T2DM . Methods One hundred and twenty consenting adult Saudi T2DM patients ( naïve or newly diagnosed and without co-morbidities ) will be enrolled in this clinical trial and r and omized to receive daily placebo or probiotics ( Ecologic ® Barrier ) for 26 weeks in a double-blind manner . Inflammatory and metabolic markers will be measured and fecal sample s analyzed . Measurements / sample s will be obtained at baseline and after 4 , 8 , 12/13 and 26 weeks of treatment . Discussion It is expected that the probiotic product will induce beneficial changes in gut microbiota , reduce the systemic inflammatory state through altering systemic endotoxin levels and , as such , reduce the systemic inflammatory response observed in T2DM subjects . Trial registration Clinical Trials.gov Identifier : Objective . This trial aims to examine the effects of a Probiotic Mixture ( VSL#3 ) on glycemic status and inflammatory markers , in women with GDM . Material s and Methods . Over a period of 8 weeks , 82 women with gestational diabetes were r and omly assigned to either an intervention group ( n = 41 ) which were given VSL#3 capsule or to a control group which were given placebo capsule ( n = 41 ) . Fasting plasma glucose , homeostatic model assessment of insulin resistance , glycosylated hemoglobin , high-sensitivity C-reactive protein , tumor necrosis factor-α , interleukin-6 , Interferon gamma , and interleukin-10 were measured before and after the intervention . Results . After 8 wk of supplementation FPG , HbA1c , HOMA-IR , and insulin levels remained unchanged in the probiotic and placebo groups . The comparison between the two groups showed no significant differences with FPG and HbA1c , but there were significant differences in insulin levels and HOMA-IR ( 16.6 ± 5.9 ; 3.7 ± 1.5 , resp . ) . Unlike the levels of IFN-g ( 19.21 ± 16.6 ) , there was a significant decrease in levels of IL-6 ( 3.81 ± 0.7 ) , TNF-α ( 3.10 ± 1.1 ) , and hs-CRP ( 4927.4 ± 924.6 ) . No significant 
    Output:
    