Effects of probiotic supplements on bone mineral density and bone turnover markers in postmenopausal women: A systematic review

Abstract

Background: Probiotics have garnered attention for their potential to influence bone health through interactions with the gut microbiota. This systematic review evaluates the effects of probiotic interventions on bone mineral density (BMD) and bone turnover markers in postmenopausal women who are at the risk of osteopenia or osteoporosis.

Methods: A thorough search across databases from January 2010 to April 2024 identified relevant randomized controlled trials (RCTs). Eligible studies explored the relationship of consumption of probiotics with bone health parameters, with data screening, extraction, and quality assessment performed based on predefined criteria.

Results: Eight RCTs were included, investigating various probiotic interventions. The analysis showed no significant impact of probiotics on hip BMD [standardized mean difference (SMD) = 0.17, 95 % confidence intervals (CIs): -0.16 to 0.50] or spine BMD (SMD = 0.04, 95 % CIs: -0.14 to 0.22). Similarly, no significant effects were observed in bone formation markers (SMD = -0.12, 95 % CI: -0.34 to 0.11). However, bone resorption markers showed marginal but significant effects (SMD = -0.19, 95 % CI: -0.40 to 0.01). Heterogeneity ranged from low to moderate, and publication bias was not significant.

Conclusion: Our results did not show a significant relationship of probiotic consumption with the BMD and bone formation in human studies. However, the observed changes in bone resorption markers indicate a potentially beneficial effects of probiotics. Although probiotics may not serve as a primary treatment for osteoporosis, they could be incorporated into a comprehensive bone health strategy.

Keywords: Bone mineral density (BMD); Bone resorption; Bone turnover markers; Gut microbiota; Osteoporosis.