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Impact of bacterial probiotics on obesity, diabetes and non-alcoholic fatty liver disease related variables: a systematic review and meta-analysis of randomised controlled trials
Open accessAbstract
Objective: To systematically review the effect of oral intake of bacterial probiotics on 15 variables related to obesity, diabetes and non-alcoholic fatty liver disease. Design: Systematic review and meta-analysis. Data sources: Medline, EMBASE and COCHRANE from 1990 to June 2018. Eligibility criteria: Randomised controlled trials (≥14 days) excluding hypercholesterolaemia, alcoholic liver disease, polycystic ovary syndrome and children <3 years. Results: One hundred and five articles met inclusion criteria, representing 6826 subjects. In overweight but not obese subjects, probiotics induced improvements in: body weight (k=25 trials, d=−0.94 kg mean difference, 95% CI −1.17 to −0.70, I²=0.0%), body mass index (k=32, d=−0.55 kg/m², 95% CI −0.86 to −0.23, I²=91.9%), waist circumference (k=13, d=−1.31 cm, 95% CI −1.79 to −0.83, I²=14.5%), body fat mass (k=11, d=−0.96 kg, 95% CI −1.21 to −0.71, I²=0.0%) and visceral adipose tissue mass (k=5, d=−6.30 cm², 95% CI −9.05 to −3.56, I²=0.0%). In type 2 diabetics, probiotics reduced fasting glucose (k=19, d=−0.66 mmol/L, 95% CI −1.00 to −0.31, I²=27.7%), glycated haemoglobin (k=13, d=−0.28 pp, 95% CI −0.46 to −0.11, I²=54.1%), insulin (k=13, d=−1.66 mU/L, 95% CI −2.70 to −0.61, I²=37.8%) and homeostatic model of insulin resistance (k=10, d=−1.05 pp, 95% CI −1.48 to −0.61, I²=18.2%). In subjects with fatty liver diseases, probiotics reduced alanine (k=12, d=−10.2 U/L, 95% CI −14.3 to −6.0, I²=93.50%) and aspartate aminotransferases (k=10, d=−9.9 U/L, 95% CI −14.1 to -5.8, I²=96.1%). These improvements were mostly observed with bifidobacteria ( Bifidobacterium breve , B. longum ), Streptococcus salivarius subsp . thermophilus and lactobacilli ( Lactobacillus acidophilus , L. casei , L. delbrueckii ) containing mixtures and influenced by trials conducted in one country. Conclusions: The intake of probiotics resulted in minor but consistent improvements in several metabolic risk factors in subjects with metabolic diseases. Trial registration number: CRD42016033273.
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“Therapies targeted against the gut microbiota have been shown to improve the metabolic function in humans [2, 3]”
From Dietary lipids, gut microbiota and lipid metabolism (2019) · cites this paper as [3]
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“In another meta-analysis study, it was shown that the probiotic strains B. breve, B. longum, S. thermophilus, L. acidophilus, L. delbrueckii, and L. casei can have a positive impact on anthropometric results and also on the metabolic risk factors (e.g., fasting glucose in individual glucose or insulin) in subjects with metabolic diseases [141].”
From The Potential Impact of Probiotics on Human Health: An Update on Their Health-Promoting Properties (2024) · cites this paper as [141]
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“Interestingly, a meta-analysis showed that probiotic strains from specific taxa (Bifidobacterium breve, B. longum Streptococcus thermophilus Lactobacillus acidophilus, L. delbrueckii, and Lacticaseibacillus casei) may positively impact anthropometric outcomes and metabolic risk factors such as fasting glucose or insulin in individuals with metabolic diseases (Koutnikova et al., 2019).”
From Viral Infections, the Microbiome, and Probiotics (2021) · cites this paper as Koutnikova et al., 2019
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Metadata
- Authors
- Koutnikova, H., Genser, B., Monteiro-Sepulveda, M., Faurie, J.-M., Rizkalla, S., Schrezenmeir, J., & Clément, K.
- Affiliations
- Danone Nutricia Research, Palaiseau, France
- University of Mannheim (DE)
- Assistance Publique – Hôpitaux de Paris (FR)
- Danone (France) (FR)
- Johannes Gutenberg University Mainz (DE)
- Inserm (FR)
- Corresponding author
- Clément, Karine
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2019-03
- Volume
- 9
- Issue
- 3
- Pages
- e017995
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC6475231
- OpenAlex
- W2925399545
- Cited by
- 299
- References
- 144
- Citations by year
- 2026: 22 · 2025: 31 · 2024: 52 · 2023: 39 · 2022: 53 · 2021: 45 · 2020: 45 · 2019: 11
- FWCI
- 3.47
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Danone Research
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Keywords
- probiotics, obesity, type 2 diabetes, non-alcoholic fatty liver disease, overweight, body weight, body mass index, waist circumference, visceral adipose tissue, fasting blood glucose, HbA1c, insulin resistance, insulin sensitivity, gut microbiota, intestinal barrier, intestinal permeability
- MeSH terms
- Diabetes Mellitus, Humans, Obesity, Randomized Controlled Trials as Topic, Treatment Outcome, Dietary Supplements, Probiotics, Non-alcoholic Fatty Liver Disease
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