Efficacy of Probiotics and Synbiotics in Patients with Nonalcoholic Fatty Liver Disease: A Meta-Analysis

Jun 17, 2019Digestive diseases and sciences

Probiotics and Synbiotics May Help People with Nonalcoholic Fatty Liver Disease: A Combined Study

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Abstract

Analysis of 15 randomized, controlled trials involving 782 patients suggests that probiotics and synbiotics supplementation may significantly improve several liver-related health markers in individuals with nonalcoholic fatty liver disease (NAFLD).

Probiotics and synbiotics supplementation is associated with improvements in liver steatosis and liver enzymes.
Significant reductions in triglycerides, total cholesterol, and low-density lipoprotein levels were observed.
Improvements in insulin resistance and liver stiffness were noted following supplementation.
No significant changes were found in body mass index, waist circumference, or fasting blood sugar levels.

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BACKGROUND AND AIM: Extensive epidemiological evidence suggests that nonalcoholic fatty liver disease (NAFLD) is the primary chronic liver disease worldwide. However, some studies have showed conflicting results on the effects of probiotics and synbiotics supplementation. Therefore, we conducted a systematic review and meta-analysis to investigate the effectiveness of the supplementation in subjects with NAFLD.

METHODS: We searched systematically PubMed, Cochrane, and Embase databases up to April 2018 and checked manually the bibliography of the original articles. The quality of the studies was evaluated using the Cochrane Risk of Bias Tool.

RESULTS: This study analyzed 15 randomized, controlled trials involving 782 patients with NAFLD. Probiotics and synbiotics supplementation could significantly improve liver steatosis, alanine aminotransferase, aspartate aminotransferase, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein, homeostasis model assessment-insulin resistance, liver stiffness and tumor necrosis factor-alpha (all P < 0.05). But the supplementation could not ameliorate body mass index (mean difference [MD] = -0.00; 95% confidence interval [CI]: -0.22 to 0.22, P = 0.99), waist circumference (MD = -0.01; 95% CI -0.03 to 0.02, P = 0.57) and fasting blood sugar (standard mean difference [SMD] = -0.10; 95% CI -0.32 to 0.12, P = 0.39).

CONCLUSION: We present clear evidence for the benefit of probiotics and synbiotics supplementation for liver steatosis, liver enzymes, lipid profiles and liver stiffness in patients with NAFLD.

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Efficacy of Probiotics and Synbiotics in Patients with Nonalcoholic Fatty Liver Disease: A Meta-Analysis

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