{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T13:23:48Z","timestamp":1773235428551,"version":"3.50.1"},"reference-count":80,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T00:00:00Z","timestamp":1666656000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Scientific Employment Stimulus\u2014Second Edition","doi-asserted-by":"publisher","award":["CEECIND\/01070\/2018"],"award-info":[{"award-number":["CEECIND\/01070\/2018"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Metabolic syndrome (MS) comprises a vast range of metabolic dysfunctions, which can be associated to cardiovascular disease risk factors. MS is reaching pandemic levels worldwide and it currently affects around 25% in the adult population of developed countries. The definition states for the diagnosis of MS may be clear, but it is also relevant to interpret the patient data and realize whether similar criteria were used by different clinicians. The different criteria explain, at least in part, the controversies on the theme. Several studies are presently focusing on the microbiota changes according to the components of MS. It is widely accepted that the gut microbiota is a regulator of metabolic homeostasis, being the gut microbiome in MS described as dysbiotic and certain taxonomic groups associated to metabolic changes. Probiotics, and more recently synbiotics, arise as promising therapeutic alternatives that can mitigate some metabolic disturbances, namely by correcting the microbiome and bringing homeostasis to the gut. The most recent studies were revised and the promising results and perspectives revealed in this review.<\/jats:p>","DOI":"10.3390\/nu14214490","type":"journal-article","created":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T02:47:26Z","timestamp":1666752446000},"page":"4490","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Microbiota Modulation in Patients with Metabolic Syndrome"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7382-4834","authenticated-orcid":false,"given":"Ricardo","family":"Araujo","sequence":"first","affiliation":[{"name":"Nephrology & Infectious Diseases R&D Group, i3S\u2014Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade, Universidade do Porto, 4200-135 Porto, Portugal"},{"name":"INEB\u2014Instituto de Engenharia Biom\u00e9dica, Universidade do Porto, 4200-135 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2929-3751","authenticated-orcid":false,"given":"Marta","family":"Borges-Canha","sequence":"additional","affiliation":[{"name":"Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"given":"Pedro","family":"Pimentel-Nunes","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, 4200-319 Porto, Portugal"},{"name":"RISE@CI-IPOP (Health Research Network, IPO Porto), Porto Comprehensive Cancer Center (Porto CCC), 4200-072 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s11906-018-0812-z","article-title":"The Global Epidemic of the Metabolic Syndrome","volume":"20","author":"Saklayen","year":"2018","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"8","DOI":"10.2337\/dc06-1414","article-title":"The National Cholesterol Education Program\u2014Adult Treatment Panel III, International Diabetes Federation, and World Health Organization Definitions of the Metabolic Syndrome as Predictors of Incident Cardiovascular Disease and Diabetes","volume":"30","author":"Lorenzo","year":"2007","journal-title":"Diabetes Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1210\/er.2008-0024","article-title":"The Metabolic Syndrome","volume":"29","author":"Cornier","year":"2008","journal-title":"Endocr. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.clindermatol.2017.09.004","article-title":"Pathophysiology of the metabolic syndrome","volume":"36","author":"McCracken","year":"2018","journal-title":"Clin. Dermatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1161\/CIRCULATIONAHA.105.169404","article-title":"Diagnosis and management of the metabolic syndrome: An American Heart Association\/National Heart, Lung, and Blood Institute scientific statement","volume":"112","author":"Grundy","year":"2005","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1038\/nature14177","article-title":"Genetic studies of body mass index yield new insights for obesity biology","volume":"518","author":"Locke","year":"2015","journal-title":"Nature"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1038\/nature21363","article-title":"Inflammation, metaflammation and immunometabolic disorders","volume":"542","author":"Hotamisligil","year":"2017","journal-title":"Nature"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1101\/gad.346312.120","article-title":"Chronic tissue inflammation and metabolic disease","volume":"35","author":"Lee","year":"2021","journal-title":"Genes Dev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4806","DOI":"10.2174\/1381612811319270003","article-title":"Cardiac Dysfunction and Oxidative Stress in the Metabolic Syndrome: An Update on Antioxidant Therapies","volume":"19","author":"Ilkun","year":"2013","journal-title":"Curr. Pharm. Des."},{"key":"ref_10","first-page":"e1082","article-title":"AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"139","author":"Grundy","year":"2019","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1126\/science.1124234","article-title":"Metagenomic Analysis of the Human Distal Gut Microbiome","volume":"312","author":"Gill","year":"2006","journal-title":"Science"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1038\/nature06244","article-title":"The Human Microbiome Project","volume":"449","author":"Turnbaugh","year":"2007","journal-title":"Nature"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"108983","DOI":"10.1016\/j.intimp.2022.108983","article-title":"The emerging role of microbiota-derived short-chain fatty acids in immunometabolism","volume":"110","author":"Jasim","year":"2022","journal-title":"Int. Immunopharmacol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"15718","DOI":"10.1073\/pnas.0407076101","article-title":"The Gut Microbiota as an Environmental Factor That Regulates Fat Storage","volume":"101","author":"Ding","year":"2004","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1073\/pnas.0605374104","article-title":"Mechanisms underlying the resistance to diet-induced obesity in germ-free mice","volume":"104","author":"Manchester","year":"2007","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.cmet.2014.07.006","article-title":"Microbial Modulation of Insulin Sensitivity","volume":"20","author":"Khan","year":"2014","journal-title":"Cell Metab."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/s13073-022-01092-0","article-title":"Metabolic control by the microbiome","volume":"14","author":"Cox","year":"2022","journal-title":"Genome Med."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Su, X., Gao, Y., and Yang, R. (2022). Gut Microbiota-Derived Tryptophan Metabolites Maintain Gut and Systemic Homeostasis. Cells, 11.","DOI":"10.3390\/cells11152296"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"E183","DOI":"10.1017\/S0029665120001317","article-title":"Differences in gut microbiota composition in metabolic syndrome and type 2 diabetes subjects in a multi-ethnic population: The HELIUS study","volume":"79","author":"Deschasaux","year":"2020","journal-title":"Proc. Nutr. Soc."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Pircalabioru, G.G., Ilie, I., Oprea, L., Picu, A., Petcu, L.M., Burlibasa, L., Chifiriuc, M.-C., and Musat, M. (2022). Microbiome, Mycobiome and Related Metabolites Alterations in Patients with Metabolic Syndrome\u2014A Pilot Study. Metabolites, 12.","DOI":"10.3390\/metabo12030218"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"682721","DOI":"10.3389\/fmicb.2021.682721","article-title":"A Metagenome-Wide Association Study of the Gut Microbiome and Metabolic Syndrome","volume":"12","author":"Qin","year":"2021","journal-title":"Front. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1186\/s13073-021-01007-5","article-title":"Population study of the gut microbiome: Associations with diet, lifestyle, and cardiometabolic disease","volume":"13","author":"Walker","year":"2021","journal-title":"Genome Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"804455","DOI":"10.3389\/fendo.2022.804455","article-title":"Taxonomic and Functional Fecal Microbiota Signatures Associated With Insulin Resistance in Non-Diabetic Subjects With Overweight\/Obesity Within the Frame of the PREDIMED-Plus Study","volume":"13","author":"Atzeni","year":"2022","journal-title":"Front. Endocrinol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"823262","DOI":"10.3389\/fcimb.2021.823262","article-title":"Gut Microbiome Alterations in Patients With Visceral Obesity Based on Quantitative Computed Tomography","volume":"11","author":"Yan","year":"2021","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/s13059-017-1194-2","article-title":"Relationships between gut microbiota, plasma metabolites, and metabolic syndrome traits in the METSIM cohort","volume":"18","author":"Org","year":"2017","journal-title":"Genome Biol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"46337","DOI":"10.1038\/srep46337","article-title":"Indolepropionic acid and novel lipid metabolites are associated with a lower risk of type 2 diabetes in the Finnish Diabetes Prevention Study","volume":"7","author":"Paananen","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1038\/nature18309","article-title":"Acetate mediates a microbiome\u2013brain\u2013\u03b2-cell axis to promote metabolic syndrome","volume":"534","author":"Perry","year":"2016","journal-title":"Nature"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1053\/j.gastro.2012.06.031","article-title":"Transfer of Intestinal Microbiota From Lean Donors Increases Insulin Sensitivity in Individuals With Metabolic Syndrome","volume":"143","author":"Vrieze","year":"2012","journal-title":"Gastroenterology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/iid3.538","article-title":"Multidirectional facets of obesity management in the metabolic syndrome population after liver transplantation","volume":"10","author":"Czarnecka","year":"2022","journal-title":"Immun. Inflamm. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.jfda.2018.12.011","article-title":"Next generation probiotics in disease amelioration","volume":"27","author":"Chang","year":"2019","journal-title":"J. Food Drug Anal."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/j.clnu.2013.12.006","article-title":"The effects of co-administration of probiotics with herbal medicine on obesity, metabolic endotoxemia and dysbiosis: A randomized double-blind controlled clinical trial","volume":"33","author":"Lee","year":"2014","journal-title":"Clin. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Stadlbauer, V., Leber, B., Lemesch, S., Trajanoski, S., Bashir, M., Horvath, A., Tawdrous, M., Stojakovic, T., Fauler, G., and Fickert, P. (2015). Lactobacillus casei Shirota Supplementation Does Not Restore Gut Microbiota Composition and Gut Barrier in Metabolic Syndrome: A Randomized Pilot Study. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0141399"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"16079","DOI":"10.3748\/wjg.v20.i43.16079","article-title":"Gut microbiota and metabolic syndrome","volume":"20","author":"Festi","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1002\/emmm.201100159","article-title":"Intestinal mucosal adherence and translocation of commensal bacteria at the early onset of type 2 diabetes: Molecular mechanisms and probiotic treatment","volume":"3","author":"Amar","year":"2011","journal-title":"EMBO Mol. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1016\/j.cell.2016.10.043","article-title":"A Dietary Fiber-Deprived Gut Microbiota Degrades the Colonic Mucus Barrier and Enhances Pathogen Susceptibility","volume":"167","author":"Desai","year":"2016","journal-title":"Cell"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.jhep.2019.10.003","article-title":"The gut-liver axis in liver disease: Pathophysiological basis for therapy","volume":"72","author":"Albillos","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.cmet.2018.07.001","article-title":"Impaired Aryl Hydrocarbon Receptor Ligand Production by the Gut Microbiota Is a Key Factor in Metabolic Syndrome","volume":"28","author":"Natividad","year":"2018","journal-title":"Cell Metab."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1080\/17474124.2018.1503947","article-title":"Health benefits of Mediterranean diet in nonalcoholic fatty liver disease","volume":"12","author":"Abenavoli","year":"2018","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1007\/s40495-019-00187-4","article-title":"Dietary Additives and Supplements Revisited: The Fewer, the Safer for Gut and Liver Health","volume":"5","author":"Golonka","year":"2019","journal-title":"Curr. Pharmacol. Rep."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1600622","DOI":"10.1002\/mnfr.201600622","article-title":"A synbiotic composed of Lactobacillus fermentum CECT5716 and FOS prevents the development of fatty acid liver and glycemic alterations in rats fed a high fructose diet associated with changes in the microbiota","volume":"61","author":"Aransay","year":"2017","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Park, S., Kang, J., Choi, S., Park, H., Hwang, E., Kang, Y., Kim, A., Holzapfel, W., and Ji, Y. (2018). Cholesterol-lowering effect of Lactobacillus rhamnosus BFE5264 and its influence on the gut microbiome and propionate level in a murine model. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0203150"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2802","DOI":"10.1038\/s41467-018-05249-7","article-title":"Bilophila wadsworthia aggravates high fat diet induced metabolic dysfunctions in mice","volume":"9","author":"Natividad","year":"2018","journal-title":"Nat. Commun."},{"key":"ref_43","first-page":"E1306","article-title":"Probiotics modulated gut microbiota suppresses hepatocellular carcinoma growth in mice","volume":"113","author":"Li","year":"2016","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.alcohol.2008.03.131","article-title":"Alcohol, intestinal bacterial growth, intestinal permeability to endotoxin, and medical consequences: Summary of a symposium","volume":"42","author":"Purohit","year":"2008","journal-title":"Alcohol"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1007\/s10482-020-01445-y","article-title":"Administration of indigenous probiotics modulate high-fat diet-induced metabolic syndrome in Sprague Dawley rats","volume":"113","author":"Khanna","year":"2020","journal-title":"Antonie van Leeuwenhoek"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"121","DOI":"10.3920\/BM2018.0028","article-title":"Probiotic or synbiotic alters the gut microbiota and metabolism in a randomised controlled trial of weight management in overweight adults","volume":"10","author":"Hibberd","year":"2019","journal-title":"Benef. Microbes"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Vallianou, N., Christodoulatos, G.S., Karampela, I., Tsilingiris, D., Magkos, F., Stratigou, T., Kounatidis, D., and Dalamaga, M. (2021). Understanding the Role of the Gut Microbiome and Microbial Metabolites in Non-Alcoholic Fatty Liver Disease: Current Evidence and Perspectives. Biomolecules, 12.","DOI":"10.3390\/biom12010056"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1007\/s12602-021-09792-6","article-title":"Bacillus licheniformis Zhengchangsheng\u00ae Inhibits Obesity by Regulating the AMP-Activated Protein Kinase Signaling Pathway","volume":"13","author":"Lu","year":"2021","journal-title":"Probiotics Antimicrob. Proteins"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Kang, J.-H., Yun, S.-I., Park, M.-H., Park, J.-H., Jeong, S.-Y., and Park, H.-O. (2013). Anti-Obesity Effect of Lactobacillus gasseri BNR17 in High-Sucrose Diet-Induced Obese Mice. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0054617"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"F\u00e5k, F., and B\u00e4ckhed, F. (2012). Lactobacillus reuteri Prevents Diet-Induced Obesity, but not Atherosclerosis, in a Strain Dependent Fashion in Apoe\u2212\/\u2212 Mice. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0046837"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"111560","DOI":"10.1016\/j.biopha.2021.111560","article-title":"Probiotics-rich emulsion improves insulin signalling in Palmitate\/Oleate-challenged human hepatocarcinoma cells through the modulation of Fetuin-A\/TLR4-JNK-NF-\u03baB pathway","volume":"139","author":"Mularczyk","year":"2021","journal-title":"Biomed. Pharmacother."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1017\/S0007114511004491","article-title":"Bifidobacterium adolescentis supplementation ameliorates visceral fat accumulation and insulin sensitivity in an experimental model of the metabolic syndrome","volume":"107","author":"Chen","year":"2011","journal-title":"Br. J. Nutr."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"\u00c1lvarez-Mercado, A.I., Navarro-Oliveros, M., Robles-S\u00e1nchez, C., Plaza-D\u00edaz, J., S\u00e1ez-Lara, M.J., Mu\u00f1oz-Quezada, S., Fontana, L., and Abad\u00eda-Molina, F. (2019). Microbial Population Changes and Their Relationship with Human Health and Disease. Microorganisms, 7.","DOI":"10.3390\/microorganisms7030068"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1700440","DOI":"10.1002\/mnfr.201700300","article-title":"Consumption of Two Healthy Dietary Patterns Restored Microbiota Dysbiosis in Obese Patients with Metabolic Dysfunction","volume":"61","author":"Haro","year":"2017","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1097\/MPG.0b013e318263066c","article-title":"Probiotics to Adolescents with Obesity","volume":"55","author":"Larsen","year":"2012","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1038\/ejcn.2012.103","article-title":"The influence of probiotic supplementation on gut permeability in patients with metabolic syndrome: An open label, randomized pilot study","volume":"66","author":"Leber","year":"2012","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.atherosclerosis.2015.05.005","article-title":"Effect of Lactobacillus casei Shirota supplementation on trimethylamine-N-oxide levels in patients with metabolic syndrome: An open-label, randomized study","volume":"242","author":"Tripolt","year":"2015","journal-title":"Atherosclerosis"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"89","DOI":"10.3168\/jds.2012-5863","article-title":"Short communication: Effect of supplementation with Lactobacillus casei Shirota on insulin sensitivity, \u03b2-cell function, and markers of endothelial function and inflammation in subjects with metabolic syndrome\u2014A pilot study","volume":"96","author":"Tripolt","year":"2013","journal-title":"J. Dairy Sci."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Tenorio-Jim\u00e9nez, C., Mart\u00ednez-Ram\u00edrez, M.J., Del Castillo-Codes, I., Arraiza-Irigoyen, C., Tercero-Lozano, M., Camacho, J., Chueca, N., Garc\u00eda, F., Olza, J., and Plaza-D\u00edaz, J. (2019). Lactobacillus reuteri V3401 Reduces Inflammatory Biomarkers and Modifies the Gastrointestinal Microbiome in Adults with Metabolic Syndrome: The PROSIR Study. Nutrients, 11.","DOI":"10.3390\/nu11081761"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Tenorio-Jim\u00e9nez, C., Mart\u00ednez-Ram\u00edrez, M.J., Tercero-Lozano, M., Arraiza-Irigoyen, C., Del Castillo-Codes, I., Olza, J., Plaza-D\u00edaz, J., Fontana, L., Migueles, J.H., and Olivares, M. (2018). Evaluation of the effect of Lactobacillus reuteri V3401 on biomarkers of inflammation, cardiovascular risk and liver steatosis in obese adults with metabolic syndrome: A randomized clinical trial (PROSIR). BMC Complement. Altern. Med., 18.","DOI":"10.1186\/s12906-018-2371-x"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1994270","DOI":"10.1080\/19490976.2021.1994270","article-title":"Serum metabolite profiling yields insights into health promoting effect of A. muciniphila in human volunteers with a metabolic syndrome","volume":"13","author":"Depommier","year":"2021","journal-title":"Gut Microbes"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2991","DOI":"10.1016\/j.dsx.2018.07.016","article-title":"Probiotic and synbiotic supplementation could improve metabolic syndrome in prediabetic adults: A randomized controlled trial","volume":"13","author":"Kassaian","year":"2018","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2967977","DOI":"10.1155\/2022\/2967977","article-title":"Efficacy of the Synbiotic Supplementation on the Metabolic Factors in Patients with Metabolic Syndrome: A Randomized, Triple-Blind, Placebo-Controlled Trial","volume":"2022","author":"Rahimi","year":"2022","journal-title":"Int. J. Clin. Pract."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1017\/S0007114514000919","article-title":"Effects of synbiotic supplementation on insulin resistance in subjects with the metabolic syndrome: A randomised, double-blind, placebo-controlled pilot study","volume":"112","author":"Eslamparast","year":"2014","journal-title":"Br. J. Nutr."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1080\/19390211.2018.1455788","article-title":"The Effects of Synbiotic Supplementation on Body Mass Index, Metabolic and Inflammatory Biomarkers, and Appetite in Patients with Metabolic Syndrome: A Triple-Blind Randomized Controlled Trial","volume":"16","author":"Rabiei","year":"2018","journal-title":"J. Diet. Suppl."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1007\/s00394-020-02271-8","article-title":"Impact of a short-term synbiotic supplementation on metabolic syndrome and systemic inflammation in elderly patients: A randomized placebo-controlled clinical trial","volume":"60","author":"Cicero","year":"2021","journal-title":"Eur. J. Nutr."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1038\/ejcn.2011.115","article-title":"Effect of functional yogurt NY-YP901 in improving the trait of metabolic syndrome","volume":"65","author":"Chang","year":"2011","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.numecd.2018.03.001","article-title":"The effect of daily fortified yogurt consumption on weight loss in adults with metabolic syndrome: A 10-week randomized controlled trial","volume":"28","author":"Bellissimo","year":"2018","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.nut.2018.12.011","article-title":"Effects of probiotic yogurt on glycemic indexes and endothelial dysfunction markers in patients with metabolic syndrome","volume":"62","author":"Rezazadeh","year":"2019","journal-title":"Nutrition"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/j.nut.2013.12.004","article-title":"Beneficial effects of Lactobacillus plantarum on glycemia and homocysteine levels in postmenopausal women with metabolic syndrome","volume":"30","author":"Barreto","year":"2014","journal-title":"Nutrition"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/j.nut.2015.11.001","article-title":"Beneficial effects of Bifidobacterium lactis on lipid profile and cytokines in patients with metabolic syndrome: A randomized trial. Effects of probiotics on metabolic syndrome","volume":"32","author":"Bernini","year":"2016","journal-title":"Nutrition"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.nutres.2022.02.006","article-title":"Probiotic kefir consumption improves serum apolipoprotein A1 levels in metabolic syndrome patients: A randomized controlled clinical trial","volume":"102","author":"Karagozlu","year":"2022","journal-title":"Nutr. Res."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e100266","DOI":"10.1016\/j.phanu.2021.100266","article-title":"Kefir improves blood parameters and reduces cardiovascular risks in patients with metabolic syndrome","volume":"16","author":"Endringer","year":"2021","journal-title":"PharmaNutrition"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1111\/1753-0407.12501","article-title":"Personalized microbiome-based approaches to metabolic syndrome management and prevention","volume":"9","author":"Shapiro","year":"2017","journal-title":"J. Diabetes"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"e000315","DOI":"10.1136\/bmjgast-2019-000315","article-title":"High potency multistrain probiotic improves liver histology in non-alcoholic fatty liver disease (NAFLD): A randomised, double-blind, proof of concept study","volume":"6","author":"Duseja","year":"2019","journal-title":"BMJ Open Gastroenterol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"4479","DOI":"10.1210\/jc.2008-1505","article-title":"Fetuin-A and Its Relation to Metabolic Syndrome and Fatty Liver Disease in Obese Children Before and After Weight Loss","volume":"93","author":"Reinehr","year":"2008","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_77","first-page":"51","article-title":"Improvement of lipid profile by probiotic\/protective cultures: Study in a non-carcinogenic small intestinal cell model","volume":"37","author":"Gorenjak","year":"2014","journal-title":"New Microbiol."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Ll\u00e9venes, P., Rodrigues-D\u00edez, R., Cros-Bruns\u00f3, L., Prieto, M.I., Casan\u00ed, L., Balfag\u00f3n, G., and Blanco-Rivero, J. (2020). Beneficial Effect of a Multistrain Synbiotic Prodefen\u00ae Plus on the Systemic and Vascular Alterations Associated with Metabolic Syndrome in Rats: The Role of the Neuronal Nitric Oxide Synthase and Protein Kinase A. Nutrients, 12.","DOI":"10.3390\/nu12010117"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"3150","DOI":"10.3748\/wjg.v19.i20.3150","article-title":"Protective effects of two Lactobacillus plantarum strains in hyperlipidemic mice","volume":"19","author":"Wang","year":"2013","journal-title":"World J. Gastroenterol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e00183-20","DOI":"10.1128\/mSphere.00183-20","article-title":"Secretion of Recombinant Interleukin-22 by Engineered Lactobacillus reuteri Reduces Fatty Liver Disease in a Mouse Model of Diet-Induced Obesity","volume":"5","author":"Oh","year":"2020","journal-title":"mSphere"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/21\/4490\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:02:40Z","timestamp":1760144560000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/21\/4490"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,25]]},"references-count":80,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["nu14214490"],"URL":"https:\/\/doi.org\/10.3390\/nu14214490","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,25]]}}}