Postprandial lipidemia (PL) is mainly responsible for Non-fasting lipidemia (nFL) which has been perceived as a major cardiovascular disease (CVD) that can be as hazardous as fasting lipidemia (FL). Although there are limited therapies that can effectively target PL, PL tends to be a typical characteristic of dyslipidemia in patients of Type 2 Diabetes (T2D). For a study, researchers aimed to see whether a therapy that combines probiotics (Prob) with berberine (BBR), a well-established antidiabetic and hypolipidemic treatment that alters the gut microbiome, would be able to target effectively PL in T2D and investigate the basic workings. The outcome of 365 patients with T2D from the Probiotics and BBR on the Efficacy and Change of Gut Microbiota in Patients with Newly Diagnosed Type 2 Diabetes (PROMOTE study) was evaluated in terms of blood PL (120 minutes after ingesting a standard carbohydrate meal of 100g). Prob+BBR was superior to BBR or Prob alone in enhancing postprandial total cholesterol (pTC) and low-density lipoprotein cholesterol (pLDLc) levels, with a reduction in a variety of postprandial lipidomic metabolites after 3 months of follow-up.

This Bifidobacterium species is resistant to the antibiotic tetracycline and has a beneficial effect on the host. This strain’s fecal Bifidobacterium breve level changed in response to BBR therapy or a combination of Prob and BBR, suggesting that it has an impact on inflammation and gut microbiota. The genome of this B. breve strain contains four fadD genes that encode long-chain acyl-CoA synthetase and are transcriptionally induced by BBR. In Vitro, BBR treatment decreased the concentration of FFA in the culture medium of B. breve compared to vehicle. As a result, the activation of fadD by BBR might help facilitate FFA influx and mobilization in B. breve, reducing intraluminal lipids for absorption to mediate the effect of Prob+BBR on postprandial lipidemia. 

From the study, researchers found that Prob+BBR is a more effective way of treating diabetes and cardiovascular diseases than using either Prob or BBR alone. B. breve and Prob (B. breve) might have a supplementary hypolipidemic effect on PL, functioning as a lipid sink in the gut to improve blood lipids and CVD risk management in T2D.