Effects of Microecological Preparations on Obese Patients after Bariatric Surgery: A Systematic Review and Meta‐Analysis

Abstract

Vitamin deficiency, bacterial overgrowth, and gastrointestinal symptoms can be detected in obese patients after bariatric surgery that influences their quality of life (QoL) and weight. It is unclear if microecological preparations benefit obese patients following bariatric surgery. The aim of this study is to investigate the effects of microecological preparations on QoL, excess weight loss (EWL), and levels of vitamin B12 and inflammatory markers. We searched seven databases to identify reports published till December 1, 2019, and included randomized controlled trials investigating the effects of microecological preparations in obese adults undergoing bariatric surgery. The primary outcomes included QoL and EWL, while secondary outcomes comprised serum levels of vitamin B12, interleukin 6, TNF-α, and C-reactive protein (CRP). Study bias was analyzed using the Cochrane risk-of-bias tool. Statistical analyses were performed using Review Manager. The mean difference in outcomes was calculated using standardized mean difference (SMD) with a confidence interval (CI) of 95%. A majority of the studies showed a low or moderate risk of bias. Meta-analysis showed significantly higher levels of vitamin B12 in postoperative patients administered with microecological preparations (SMD = 0.52; 95% CI = 0.08–0.95; P=0.02). There were no significant differences in QoL (SMD = −0.14; 95% CI = −0.45–0.17; P=0.38), EWL (SMD = 0.45; 95% CI = −0.16–1.05; P=0.15), and levels of TNF-α (SMD = −0.29; 95% CI = −0.64–0.05; P=0.09), interleukin 6 (SMD = −0.1; 95% CI = −0.81–0.61; P=0.78]), and CRP (SMD = 0.02; 95% CI = −0.32–0.36; P=0.93). The trials examined indicated that microecological preparations had limited efficacy in improving QoL, EWL, and inflammatory response, but they stimulated the synthesis of vitamin B12. This may help in designing efficient microecological preparations to supplement bariatric surgery in obese individuals.

The effects of prebiotic, probiotic or synbiotic supplementation on overweight/obesity indicators: an umbrella review of the trials’ meta-analyses

“…In addition, in some studies, the effect of consuming prebiotics, probiotics, and synbiotics was not reported separately, and their collective impact was stated in comparison with the control group. BMI ( 56 , 110 ) and weight reduction ( 56 , 111 ) were observed in some studies, but a neutral effect on BMI ( 112 ) and EWL% ( 113 ) was found in others.…”

The Role of Probiotics in Inflammation Associated with Major Surgery: A Narrative Review

“…In accordance with the previous study, other investigators have found no relation between the use of perioperative probiotics/symbiotics and the attenuation of postoperative inflammatory markers [ 69 , 70 , 71 , 73 , 89 , 90 ]. Furthermore, in a meta-analysis that included studies with obese patients who were scheduled to have bariatric surgery, it was found that the perioperative use of pro-/pre-/symbiotics did not have a statistically significant effect on postoperative levels of CRP, IL-6, and TNF-α [ 91 ].…”

The Improvement and Related Mechanism of Microecologics on the Sports Performance and Post-Exercise Recovery of Athletes: A Narrative Review

“…The estimated market size for microecologics was about USD 850 billion in 2023, with a significant compound annual growth rate trend. Furthermore, broader research has shown that the effects of microecologics are not limited to chronic intestinal or systematic metabolic diseases but have also garnered increasing attention in recent years for their promising effects on enhancing sports performance in the athletic population [1][2][3][4]. However, there is a scarcity of reviews focusing on the effects and signaling pathways of Nutrients 2024, 16, 1602 2 of 19 microecologics specifically within this population.…”