CoChat
Sign Up
Cited by 299Probiotics and Fermented FoodsGut microbiota and healthLiver Disease Diagnosis and Treatment

The DOI matches its Crossref record; 142 of the 144 references it cites were found in a registry or an index.

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 access
Koutnikova, Hana, Genser, Bernd, Monteiro-Sepulveda, Milena, Faurie, Jean-Michel, Rizkalla, Salwa, Schrezenmeir, Jürgen, Clément, Karine·2019·BMJ Open
DOI 10.1136/bmjopen-2017-017995PMC PMC6475231
Open this paper in CoChat — free accountOpen PDF

Abstract

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.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1136/bmjopen-2017-017995

Cites

142 of 142 references verified0 citation errors · 0 not checkable

Statistics

Figures

Figure 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram.
Figure 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram.CC BY-NC · PubMed Central
Figure 2 Results of meta-analyses: overall estimates and estimates obtained in specific study populations: (A) anthropometric variables and BMI, (B) glucose homeostasis, (C) liver enzymes. (X-axis) Absolute difference in mean change from baseline (probiotics—control groups): random effects estimate and 95% CI; outcomes (measurement unit): ALAT, alanine aminotransferase; ALL, all studies pooled; ASAT, aspartate aminotransferase; BFM, body fat mass; BMI, body mass index; BW, body weight; FG, fasting glucose; GGT, gamma-glutamyl transferase; HbA1c, glycated haemoglobin; HOMA-IR, homeostatic model assessment of insulin resistance; IFG, impaired fasting glucose; INS, fasting insulin; NAFLD, non-alcoholic fatty liver disease; NW, normal weight; OB, obese; OW, overweight, T2DM, type 2 diabetes mellitus, WC, waist circumference.
Figure 2 Results of meta-analyses: overall estimates and estimates obtained in specific study populations: (A) anthropometric variables and BMI, (B) glucose homeostasis, (C) liver enzymes. (X-axis) Absolute difference in mean change from baseline (probiotics—control groups): random effects estimate and 95% CI; outcomes (measurement unit): ALAT, alanine aminotransferase; ALL, all studies pooled; ASAT, aspartate aminotransferase; BFM, body fat mass; BMI, body mass index; BW, body weight; FG, fasting glucose; GGT, gamma-glutamyl transferase; HbA1c, glycated haemoglobin; HOMA-IR, homeostatic model assessment of insulin resistance; IFG, impaired fasting glucose; INS, fasting insulin; NAFLD, non-alcoholic fatty liver disease; NW, normal weight; OB, obese; OW, overweight, T2DM, type 2 diabetes mellitus, WC, waist circumference.CC BY-NC · PubMed Central
Figure 3 Results of subgroup meta-analyses stratified by probiotics species and total number of different species administered (data shown for at least three trials): (A) body weight (kg), (b) fasting glucose (mmol/L), (C) glycated haemoglobin (%). (X-axis) Absolute difference in mean change from baseline (probiotics group—control group): random effects estimate and 95% CI. B. bif, Bifidobacterium bifidum; B. brev, Bifidobacterium breve; B. lac., Bifidobacterium animalis subsp. lactis; B. lon., Bifidobacterium longum; S. therm., Streptococcus salivarius subsp. thermophilus; Lc. lact, Lactococcus lactis; L. hel., Lactobacillus helveticus; L. acid., Lactobacillus acidophilus; L. del., Lactobacillus delbrueckii; L. gas., Lactobacillus gasseri; L. reut., Lactobacillus reuteri; L. fer., Lactobacillus fermentum; L. rham., Lactobacillus rhamnosus; L. cas. gr., Lactobacillus casei or paracasei; L. sal., Lactobacillus salivarius; L. plan., Lactobacillus plantarum.
Figure 3 Results of subgroup meta-analyses stratified by probiotics species and total number of different species administered (data shown for at least three trials): (A) body weight (kg), (b) fasting glucose (mmol/L), (C) glycated haemoglobin (%). (X-axis) Absolute difference in mean change from baseline (probiotics group—control group): random effects estimate and 95% CI. B. bif, Bifidobacterium bifidum; B. brev, Bifidobacterium breve; B. lac., Bifidobacterium animalis subsp. lactis; B. lon., Bifidobacterium longum; S. therm., Streptococcus salivarius subsp. thermophilus; Lc. lact, Lactococcus lactis; L. hel., Lactobacillus helveticus; L. acid., Lactobacillus acidophilus; L. del., Lactobacillus delbrueckii; L. gas., Lactobacillus gasseri; L. reut., Lactobacillus reuteri; L. fer., Lactobacillus fermentum; L. rham., Lactobacillus rhamnosus; L. cas. gr., Lactobacillus casei or paracasei; L. sal., Lactobacillus salivarius; L. plan., Lactobacillus plantarum.CC BY-NC · PubMed Central

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

4 retracted

Research works printed but not linked: 3

  1. 2018, EFSA Journal, 16, e05315
  2. 10.2307/2669529 · DOI
  3. 10.1177/1074248414555004 · DOI · Paper page

Cited by

Sorted by citations

See all 299

Related

See all

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
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2019-03
Volume
9
Issue
3
Pages
e017995
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2017-017995
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
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

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review