Effects of Probiotics on Metabolic Syndrome: A Systematic Review of Randomized Clinical Trials
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The aim of this systematic review is to evaluate whether the use of probiotics has any effect on the components of metabolic syndrome (MetS) before patients develop type 2 diabetes. A qualitative systematic review, following the Cochrane methodology, and a comprehensive literature search of randomized controlled trials (RCTs) were conducted in PubMed and Scopus from inception until 4 July 2019. According to our inclusion criteria, nine clinical studies were finally analyzed, corresponding to six RCTs. Probiotics intake in patients with MetS resulted in improvements in body mass index, blood pressure, glucose metabolism, and lipid profile in some studies. Regarding inflammatory biomarkers, probiotics also positively affected the soluble vascular cell adhesion molecule 1 (sVCAM-1), interleukine-6 (IL-6), tumor necrosis factor α (TNF-α), vascular endothelial growth factor (VEGF), and thrombomodulin. Despite the diversity of the published studies, the intake of probiotics for patients with MetS may offer a discrete improvement in some of the clinical characteristics of the MetS and a decrease in inflammatory biomarkers. Nevertheless, these beneficial effects seem to be marginal compared to drug therapy and a healthy lifestyle and clinically non-relevant.
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Clinical outcomes of probiotics vary widely because host genetics, baseline microbiota, diet, medications, and comorbidities modulate response and susceptibility, explaining heterogeneous results across studies.
“Clinical outcomes vary widely because host genetics, baseline microbiota, diet, medications, and comorbidities modulate response and susceptibility, which explains the heterogeneous results across studies [15,114,115].”
From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [15]
The Discussion reports heterogeneous probiotic studies and attributes differences chiefly to study populations, probiotic strains, doses, delivery forms, and intervention duration. It recommends measuring gut microbiota composition, but does not establish that host genetics, baseline microbiota, diet, medications, and comorbidities modulate probiotic response or explain the heterogeneous outcomes. (LLM, conf=0.84)
Experimental — accuracy not yet measuredStudies show a wide range of probiotic doses, from 10^8 to 10^11 cells or CFU, and different administration forms may cause further differences.
“For example, studies show a wide range of doses, ranging from 108 to 1011 cells or CFU, and different forms of administration (cheese, yogurt and milk, or probiotic capsule) may also cause further differences [14,15].”
From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [15]
In some probiotic studies, the duration of exposure of 3-6 weeks may have been insufficient to detect changes.
“In some studies, the duration of exposure (3–6 weeks) may have been insufficient to detect changes [14,15].”
From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [15]
The clinical implications of sex differences in probiotic studies are unclear.
“The clinical implications of this issue are unclear [15,136].”
From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [15]
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- Authors
- Tenorio-Jiménez, C., Martínez-Ramírez, M. J., Gil, Á., & Gómez-Llorente, C.
- Affiliations
- Hospital Universitario Virgen de las Nieves (ES)
- Universidad de Jaén (ES)
- Universidad de Granada (ES)
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain
- Corresponding author
- Tenorio-Jiménez, Carmen
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2020-01-01
- Volume
- 12
- Issue
- 1
- Pages
- 124
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC7019472
- OpenAlex
- W2997702368
- Cited by
- 206
- References
- 31
- Citations by year
- 2026: 17 · 2025: 20 · 2024: 14 · 2023: 102 · 2022: 17 · 2021: 24 · 2020: 11 · 2019: 1
- FWCI
- 3.26
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, cc-by)
- Institutional Repository of the University of Granada (University of Granada) (submittedVersion, cc-by)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Universidad de Granada
- Universidad de Jaén
- 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 › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- probiotics, metabolic syndrome, type 2 diabetes prevention, body mass index, blood pressure, glucose metabolism, lipid profile, inflammatory markers, soluble vascular cell adhesion molecule-1, interleukin-6, TNF-α, vascular endothelial growth factor, thrombomodulin
- MeSH terms
- Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Tumor Necrosis Factor-alpha, Biomarkers, Interleukin-6, Randomized Controlled Trials as Topic, Treatment Outcome, Thrombomodulin, Vascular Cell Adhesion Molecule-1, Probiotics, Metabolic Syndrome, Vascular Endothelial Growth Factor A, Young Adult
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