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Meta-Analysis
. 2022 Nov 3:13:1014670.
doi: 10.3389/fendo.2022.1014670. eCollection 2022.

Probiotics for the improvement of metabolic profiles in patients with metabolic-associated fatty liver disease: A systematic review and meta-analysis of randomized controlled trials

Qiuhong Wang  1 , Ze Wang  1 , Boxian Pang  2 , Huijuan Zheng  3 , Zhengmin Cao  4 , Chunpeng Feng  1 , Wenxin Ma  5 , Junping Wei  1
Affiliations
Meta-Analysis

Probiotics for the improvement of metabolic profiles in patients with metabolic-associated fatty liver disease: A systematic review and meta-analysis of randomized controlled trials

Qiuhong Wang et al. Front Endocrinol (Lausanne). .

Abstract

Objective: This meta-analysis of randomized controlled trials (RCTs) was conducted to assess the efficacy of probiotics in the treatment of metabolic-associated fatty liver disease (MAFLD) mainly in terms of liver function, glucose and lipid metabolism, and inflammation.

Methods: RCTs were searched on PubMed, Web of Science, Embase, and the Cochrane Library until June 2022. A meta-analysis was performed on the therapeutic efficacy of probiotics on liver function, glucose and lipid metabolism, and inflammatory biomarkers by using RevMan 5.4 software.

Results: A total of 772 patients from 15 studies were included in the analysis. The methodological quality varied across studies. We found that adding probiotic therapies could reduce the levels of alanine aminotransferase [mean difference (MD): -11.76 (-16.06, -7.46), p < 0.00001], aspartate aminotransferase (MD: -9.08 (-13.60, -4.56), p < 0.0001], γ-glutamyltransferase [MD: -5.67 (-6.80, -4.54), p < 0.00001] and homeostasis model assessment-insulin resistance [MD: -0.62 (-1.08, -0.15), p = 0.01], in patients with MAFLD compared with those in control individuals. However, there was no statistically significant improvement in the levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol, C-reactive protein and tumor necrosis factor α among patients with MAFLD. Subgroup analyses showed that other key factors, such as age, participants' baseline body mass index, and the duration of intervention, may influence probiotic therapy outcomes.

Conclusion: There is promising evidence that probiotic supplementation can reduce liver enzyme levels and regulate glycometabolism in patients with MAFLD. Further rigorous and long-term trials exploring these novel therapeutic perspectives are warranted to confirm these results.

Keywords: gut microbiota; gut-liver axis; liver enzymes; meta-analysis; metabolic associated fatty liver disease; probiotics; randomized controlled trials.

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Conflict of interest statement

The authors declare that they have no conflicts of interest and no financial interests related to the material in this manuscript.

Figures

Figure 1
Figure 1
Flow chart of the literature selection process.
Figure 2
Figure 2
Risk of bias graph (A) and risk of bias summary (B) for included RCTs.
Figure 3
Figure 3
Forest plot of the effect of probiotic supplementation on ALT (A). Forest plot of the effect of probiotic supplementation onAST (B).
Figure 4
Figure 4
Forest plot of the effect of probiotic supplementation on GGT (A). Forest plot of the effect of probiotic supplementation on TG (B).
Figure 5
Figure 5
Forest plot of the effect of probiotic supplementation on TC (A). Forest plot of the effect of probiotic supplementation on TC in the included studies with baseline BMIs of more than 27 kg/m2 (B).
Figure 6
Figure 6
Forest plot of the effect of probiotic supplementation on LDL-C (A). Forest plot of the effect of probiotic supplementation on HOMA-IR (B).
Figure 7
Figure 7
Forest plot of the effect of probiotic supplementation on HOMA-IR in studies with a duration of more than 8 weeks (A). Forest plot of the effect of probiotic supplementation on CRP (B).
Figure 8
Figure 8
Forest plot of the effect of probiotic supplementation on TNF-α in the included studies with baseline BMIs of less 28 kg/m2.
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References

    1. Suk KT, Kim DJ. Gut microbiota:novel therapeutic target for nonalcoholic fatty liver disease. Expert Rev Gastroenterol Hepatol (2019) 13(3):193–204. doi: 10.1080/17474124.2019.1569513 - DOI - PubMed
    1. Sheka AC, Adeyi O, Thompson J, Hameed B, Crawford PA, Ikramuddin S, et al. . Nonalcoholic steatohepatitis: A review. JAMA (2020) 323(12):1175–83. doi: 10.1001/jama.2020.2298 - DOI - PubMed
    1. Hashem A, Khalouf A, Acosta A. Management of obesity and nonalcoholic fatty liver Disease:A literature review. Semin Liver Dis (2021) 41(4):435–47. doi: 10.1055/s-0041-1731704 - DOI - PMC - PubMed
    1. Lim S, Kim JW, Targher G. Links between metabolic syndrome and metabolic dysfunction-associated fatty liver disease. Trends Endocrinol Metab (2021) 32(7):500–14. doi: 10.1016/j.tem - DOI - PubMed
    1. Rosato V, Masarone M, Dallio M, Federico A, Aglitti A, Persico M. NAFLD and extra-hepatic Comorbidities:Current evidence on a multi-organ metabolic syndrome. Int J Environ Res Public Health (2019) 16(18):3415. doi: 10.3390/ijerph16183415 - DOI - PMC - PubMed

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