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Meta-Analysis
. 2024 Nov 1:15:1487998.
doi: 10.3389/fendo.2024.1487998. eCollection 2024.

Effects of probiotic supplementation on bone health in postmenopausal women: a systematic review and meta-analysis

Fang Wang  1 , Wei Wei  1 , Peng Ju Liu  1
Affiliations
Meta-Analysis

Effects of probiotic supplementation on bone health in postmenopausal women: a systematic review and meta-analysis

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

Abstract

Context: The beneficial effects of probiotic supplementation on bone health in postmenopausal women require further validation.

Objective: This study systematically reviewed and conducted a meta-analysis of randomized controlled trials (RCTs) to assess the relationship between probiotic supplementation and changes in bone mineral density (BMD) and bone turnover markers (BTMs) among postmenopausal women.

Methods: A systematic search was conducted across four databases to retrieve data on lumbar spine BMD, hip BMD, collagen type 1 cross-linked C-telopeptide (CTX), receptor activator of nuclear factor-κB ligand (RANKL), osteocalcin (OC), osteoprotegerin (OPG), N-terminal propeptide of type 1 procollagen (P1NP), and bone-specific alkaline phosphatase (BALP) in postmenopausal women. Eligible RCTs were quantitatively analyzed using random-effects meta-analyses. Additional analyses, including subgroup, sensitivity, and meta-regression analyses, were performed.

Results: Twelve RCTs involving 1183 postmenopausal women were included. Compared with the control group, postmenopausal women who received probiotic supplementation showed significantly greater BMD in both the lumbar spine (standardized mean difference [SMD] = 0.60, 95% confidence interval [CI] 0.14 to 1.05) and the hip (SMD = 0.74, 95%CI 0.15 to 1.33). Additionally, probiotic supplementation was associated with reduced levels of CTX (SMD = -1.51, 95%CI -1.88 to -0.41) and BALP (SMD = -1.80, 95%CI -2.78 to -0.81). No significant differences were found between the probiotic and control groups in terms of other BTMs. Subgroup analyses revealed that the increase in BMD due to probiotic supplementation was more significant in postmenopausal women with osteopenia than in those with osteoporosis. The meta-analysis results for both lumbar spine and hip BMD remained robust after conducting sensitivity analyses and meta-regressions.

Conclusion: Supplementation with probiotics may increase BMD among postmenopausal women, with stronger evidence in women with osteopenia than osteoporosis. Further RCTs are suggested to confirm and refine these findings.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024576764.

Keywords: bone; bone turnover marker; osteopenia; osteoporosis; postmenopausal women; probiotic.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of study selection.
Figure 2
Figure 2
(A) Forest plot depicting the overall effect of probiotics on lumbar spine BMD. (B) Forest plot depicting the overall effect of probiotics on hip BMD.
Figure 3
Figure 3
(A) Forest plot depicting the overall effect of probiotics on CTX. (B) Forest plot depicting the overall effect of probiotics on BALP. (C) Forest plot depicting the overall effect of probiotics on P1NP. (D) Forest plot depicting the overall effect of probiotics on OC.
Figure 4
Figure 4
The potential impact of gut microbiota regulation on promoting bone health.
See this image and copyright information in PMC

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