Effects of probiotics on nonalcoholic fatty liver disease: a systematic review and meta-analysis

Yang, Ruwen; Shang, Jingyu; Zhou, Yaru; Liu, Weiwei; Tian, Yaozhou; Shang, Hongtao

doi:10.1080/17474124.2022.2016391

Cited by 31 publications

(28 citation statements)

References 28 publications

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“…Additionally, 594 original studies were excluded at a second stage due to the high number of SRs retrieved by this search. The full text of 103 articles was assessed, and after exclusion of 16 articles (see Table S3), 87 SRs were included in this umbrella review 17,26–111 …”

Section: Resultsmentioning

confidence: 99%

Human microbiome and metabolic health: An overview of systematic reviews

et al. 2022

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Summary To summarize the microbiome's role in metabolic disorders (insulin resistance, hyperglycemia, type 2 diabetes, obesity, hyperlipidemia, hypertension, nonalcoholic fatty liver disease [NAFLD], and metabolic syndrome), systematic reviews on observational or interventional studies (prebiotics/probiotics/synbiotics/transplant) were searched in MEDLINE and Embase until September 2020. The 87 selected systematic reviews included 57 meta‐analyses. Methodological quality (AMSTAR2) was moderate in 62%, 12% low, and 26% critically low. Observational studies on obesity (10 reviews) reported less gut bacterial diversity with higher Fusobacterium, Lactobacillus reuteri, Bacteroides fragilis, and Staphylococcus aureus, whereas lower Methanobrevibacter, Lactobacillus plantarum, Akkermansia muciniphila, and Bifidobacterium animalis compared with nonobese. For diabetes (n = 1), the same was found for Fusobacterium and A. muciniphila, whereas higher Ruminococcus and lower Faecalibacterium, Roseburia, Bacteroides vulgatus, and several Bifidobacterium spp. For NAFLD (n = 2), lower Firmicutes, Rikenellaceae, Ruminococcaceae, whereas higher Escherichia and Lactobacillus were detected. Discriminating bacteria overlapped between metabolic disorders, those with high abundance being often involved in inflammation, whereas those with low abundance being used as probiotics. Meta‐analyses (n = 54) on interventional studies reported 522 associations: 54% was statistically significant with intermediate effect size and moderate between‐study heterogeneity. Meta‐evidence was highest for probiotics and lowest for fecal transplant. Future avenues include better methodological quality/comparability, testing functional differences, new intervention strategies, and considerating other body habitats and kingdoms.

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Section: Resultsmentioning

confidence: 99%

Human microbiome and metabolic health: An overview of systematic reviews

et al. 2022

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“…The average dose of probiotics in studies was between 2.6 × 10 9 and 5 × 10 11 CFU. Studies were fulfilled in China ( 23 , 25 , 26 , 29 , 30 ), United States ( 31 – 33 ), India ( 34 ), and France ( 27 ). The duration of studies ranged between 8 and 20 weeks.…”

Section: Resultsmentioning

confidence: 99%

Effect of Probiotics on Liver Enzymes in Patients With Non-alcoholic Fatty Liver Disease: An Umbrella of Systematic Review and Meta-Analysis

et al. 2022

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Non-alcoholic fatty liver disease (NAFLD) has become prevalent in recent decades, especially in developed countries; yet the approaches for preventing and treating NAFLD are not clear. This study aimed to summarize meta-analyses of randomized controlled trials that examined the effects of probiotics on NAFLD. We systematically searched PubMed, Scopus, Embase, Web of Science, and Cochrane Central Library databases up to August 2021. All Meta-analysis studies assessing the effect of probiotics on liver function tests [alanine aminotransferase (ALT), aspartate aminotransferase (AST), and Gamma-glutamyl transferase (GGT)] were included. Meta-analysis was conducted using a random-effects model. Sensitivity and subgroup analyses were also performed. The umbrella study covered ten eligible studies involving 5,162 individuals. Beneficial effects of probiotics supplementation were revealed on ALT (ES = −10.54 IU/L; 95% CI: −12.70, −8.39; p < 0.001; I2 = 60.9%, p = 0.006), AST (ES = −10.19 IU/L, 95%CI: −13.08, −7.29, p < 0.001; I2 = 79.8%, p < 0.001), and GGT (ES = −5.88 IU/L, 95% CI: −7.09, −4.67, p = 0.009; I2 = 0.0%, p = 0.591) levels. Probiotics have ameliorating effects on ALT, AST, and GGT levels in patients with NAFLD. Overall, Probiotics could be recommended as an adjuvant therapeutic method for the management of NAFLD.

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“…Targeting the GI tract with probiotics in NAFLD and NASH patients has proved beneficial in reducing liver enzymes, hepatic inflammation, hepatic steatosis, and hepatic fibrosis further supporting a role for the GI tract (121)(122)(123)(124)(125)(126)(127)(128)(129)(130). Nevertheless, these studies still do not completely explain the cause of gut dysbiosis and decreased barrier function, the increased risk of IBD and CRC in NAFLD patients or how the probiotics are working.…”

Section: Discussionmentioning

confidence: 98%

Individuals with Metabolic Syndrome show altered fecal lipidomic profiles with no signs of intestinal inflammation or increased intestinal permeability: a pilot study

Coleman

Espino

Lebensohn

et al. 2022

Preprint

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Metabolic Syndrome (MetS) is a clinical diagnosis where patients exhibit three out of the five risk factors: hypertriglyceridemia, low HDL cholesterol, hyperglycemia, hypertension or increased abdominal obesity. MetS arises due to dysregulated metabolic pathways that culminate with insulin resistance and put individuals at risk to develop various comorbidities with far-reaching medical consequences such as non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease. As it stands, the exact pathogenesis of MetS as well as the involvement of the gastrointestinal tract in MetS is not fully understood. Our study aimed to evaluate intestinal health in human subjects with MetS with the goal to evaluate for any signs of underlying gut inflammation, increased intestinal permeability, and alterations in host-microbiota metabolism as assessed by fecal metabolites. No signs of intestinal inflammation or increased intestinal permeability were observed in MetS group compared to our control group. However, we found a significant increase in 417 lipid features of the gut lipidome in our MetS cohort. An identified fecal lipid, diacyl-glycerophosphocholine, showed a strong correlation with several MetS risk factors. An although our MetS cohort showed no signs of intestinal inflammation they presented with increased levels of serum TNFα that also correlated with increasing triglyceride and fecal diacyl-glycerophosphocholine levels, and decreasing HDL cholesterol levels. Taken together, our main results show MetS subjects show major alterations in fecal lipid profiles suggesting alterations in intestinal host-microbiota metabolism that may arise before concrete signs of gut inflammation or intestinal permeability become apparent. Lastly, we posit fecal metabolomics could serve as a non-invasive, accurate screening method for both MetS and NAFLD.

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Effects of probiotics on nonalcoholic fatty liver disease: a systematic review and meta-analysis

Cited by 31 publications

References 28 publications

Human microbiome and metabolic health: An overview of systematic reviews

Human microbiome and metabolic health: An overview of systematic reviews

Effect of Probiotics on Liver Enzymes in Patients With Non-alcoholic Fatty Liver Disease: An Umbrella of Systematic Review and Meta-Analysis

Individuals with Metabolic Syndrome show altered fecal lipidomic profiles with no signs of intestinal inflammation or increased intestinal permeability: a pilot study

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