The effect of probiotic consumption on lipid profile, glycemic index, inflammatory markers, and liver function in NAFLD patients: A systematic review and meta-analysis of randomized controlled trials

J Diabetes Complications. 2024 Aug;38(8):108780. doi: 10.1016/j.jdiacomp.2024.108780. Epub 2024 Jun 6.

Abstract

Background-aim: Non-alcoholic fatty liver disease (NAFLD1) is the most frequent chronic liver disorder worldwide. Currently, no pharmacological treatment has been approved for NAFLD. Probiotics have been suggested as a potential therapy for NAFLD. The aim of this systematic review and meta-analysis was to assess the impact of probiotic intake on liver tests, lipids, glycemic parameters and inflammatory markers in NAFLD patients.

Methods: We searched electronic databases using related terms. Meta-analysis was performed using random-effects models. Clinical outcomes were presented as standard mean difference (SMD2) with a 95 % confidence interval (CI3). Publication bias and heterogeneity were evaluated in eligible studies.

Results: Fifteen randomized clinical trials comprising 899 participants were included in our meta-analysis. Probiotic supplementation improved alanine transaminase [SMD -0.796; 95 % CI (-1.419, -0.172); p = 0.012], Homeostatic Model Assessment for Insulin Resistance (HOMA-IR4) [SMD -0.596; 95 % CI (-1.071, -0.121); p = 0.01] and insulin levels [SMD -1.10; 95 % CI (-2.121, -0.087); p = 0.03]. No significant effects were observed on fasting glucose, hemoglobin A1c, aspartate transaminase, lipid profile, interleukin-6 and tumor necrosis factor-α.

Conclusions: Probiotic intake may improve insulin sensitivity and alanine transaminase in NAFLD patients.

Keywords: Liver; Meta-analysis; Metabolic indices; Non-alcoholic fatty liver disease; Probiotics; Steatosis.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Biomarkers / blood
  • Blood Glucose / analysis
  • Blood Glucose / metabolism
  • Glycemic Index
  • Humans
  • Inflammation Mediators / blood
  • Insulin Resistance
  • Lipids* / blood
  • Liver / metabolism
  • Liver Function Tests
  • Non-alcoholic Fatty Liver Disease* / blood
  • Non-alcoholic Fatty Liver Disease* / complications
  • Non-alcoholic Fatty Liver Disease* / therapy
  • Probiotics* / administration & dosage
  • Probiotics* / therapeutic use
  • Randomized Controlled Trials as Topic*

Substances

  • Lipids
  • Biomarkers
  • Blood Glucose
  • Inflammation Mediators