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

Digestive Diseases and Sciences volume 64, pages 3402–3412 (2019)Cite this article

Abstract

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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Authors and Affiliations

  1. School of Graduate, Tianjin Medical University, Tianjin, China

    Liang Liu, Yiqi Liu & Yilian Zhang

  2. Department of Hepatology, Tianjin Second People’s Hospital, Tianjin, China

    Liang Liu & Ping Li

  3. Tianjin Research Institute of Liver Diseases, Tianjin, China

    Ping Li

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  1. Liang Liu
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Correspondence to Ping Li.

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Supplementary Fig.

 1. Risk of bias summary: review authors’ judgements about each risk of bias item for each included study (TIFF 369 kb)

Supplementary Fig.

 2. Risk of bias graph: review authors’ judgements about each risk of bias item presented as percentages across all included studies (TIFF 325 kb)

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Liu, L., Li, P., Liu, Y. et al. Efficacy of Probiotics and Synbiotics in Patients with Nonalcoholic Fatty Liver Disease: A Meta-Analysis. Dig Dis Sci 64, 3402–3412 (2019). https://doi.org/10.1007/s10620-019-05699-z

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  • DOI: https://doi.org/10.1007/s10620-019-05699-z

Keywords

  • Probiotics
  • Synbiotics
  • Nonalcoholic fatty liver disease
  • Meta-analysis