Effects of probiotics on nonalcoholic fatty liver disease: a systematic review and meta-analysis
Open accessAbstract
Background: Nonalcoholic fatty liver disease (NAFLD) has become prevalent in recent decades, especially in developed countries, and approaches for the prevention and treatment of NAFLD are not clear. The aim of this research was to analyze and summarize randomized controlled trials that investigated the effects of probiotics on NAFLD. Methods: Seven databases (PubMed, Embase, the Web of Science, the Cochrane Library, China National Knowledge Infrastructure, Wan Fang Data, and VIP Database) were searched. Then, eligible studies were identified. Finally, proper data extraction, synthesis and analysis were performed by trained researchers. Results: Anthropometric parameters: with use of probiotics weight was reduced by 2.31 kg, and body mass index (BMI) was reduced by 1.08 kg/m2. Liver function: probiotic treatment reduced the alanine aminotransferase level by 7.22 U/l, the aspartate aminotransferase level by 7.22 U/l, the alkaline phosphatase level by 25.87 U/l, and the glutamyl transpeptidase level by −5.76 U/l. Lipid profiles: total cholesterol, low-density lipoprotein cholesterol, and triglycerides were significantly decreased after probiotic treatment. Their overall effects (shown as standard mean difference) were −0.73, −0.54, and −0.36, respectively. Plasma glucose: probiotics reduced the plasma glucose level by 4.45 mg/dl and the insulin level by 0.63. Cytokines: probiotic treatment decreased tumor necrosis factor alpha by 0.62 and leptin by 1.14. Degree of liver fat infiltration (DFI): the related risk of probiotics for restoring DFI was 2.47 (95% confidence interval, 1.61–3.81, p < 0.001). Conclusion: Probiotic treatment or supplementation is a promising therapeutic method for NAFLD.
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In a meta-analysis of RCTs that investigated the effects of probiotics on MASLD, probiotic treatment reduced ALT, AST and liver steatosis, but the included studies had a number of limitations (e.g. short-term, small sample size, limited assessment of liver outcomes).
“In a meta-analysis of RCTs that investigated the effects of probiotics on MASLD, probiotic treatment reduced ALT, AST and liver steatosis, but the included studies had a number of limitations ( e.g. short-term, small sample size, limited assessment of liver outcomes). 337”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [337]
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- Authors
- Tang, Y., Huang, J., Zhang, W. Y., Qin, S., Yang, Y. X., Ren, H., Yang, Q.-B., & Hu, H.
- Affiliations
- Second Affiliated Hospital of Chongqing Medical University (CN)
- Chongqing Medical University (CN)
- Department of Clinical Nutrition, Tsinghua University, Beijing, China
- Corresponding author
- Hu, Huaidong
- Venue
- Therapeutic Advances in Gastroenterology
- Publisher
- SAGE Publications
- Published
- 2019-01
- Volume
- 12
- Pages
- 1756284819878046-1756284819878046
- ISSN
- 1756-283X (ISSN-L)
- 1756-2848
- PMC
- PMC6764034
- OpenAlex
- W2975167027
- Cited by
- 85
- References
- 98
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 25 · 2023: 10 · 2022: 20 · 2021: 15 · 2020: 3 · 2019: 2
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Therapeutic Advances in Gastroenterology (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- “Par-Eu Scholars Program“ of Chongqing City and the National Science and Technology Major Project of China (2012ZX10002007001)
- National Natural Science Foundation of China (81171560)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- 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
- Keywords
- probiotics, non-alcoholic fatty liver disease, liver function, lipid profile, insulin, plasma glucose, TNF-α, leptin, liver fat infiltration, body mass index, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyltranspeptidase, cholesterol, triglycerides
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