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Digestive Diseases and Sciences

, Volume 64, Issue 12, pp 3402–3412 | Cite as

Efficacy of Probiotics and Synbiotics in Patients with Nonalcoholic Fatty Liver Disease: A Meta-Analysis

  • Liang Liu
  • Ping LiEmail author
  • Yiqi Liu
  • Yilian Zhang
Review
First Online:

Abstract

Background and Aim

Extensive epidemiological evidence suggests that nonalcoholic fatty liver disease (NAFLD) is the primary chronic liver disease worldwide. However, some studies have showed conflicting results on the effects of probiotics and synbiotics supplementation. Therefore, we conducted a systematic review and meta-analysis to investigate the effectiveness of the supplementation in subjects with NAFLD.

Methods

We searched systematically PubMed, Cochrane, and Embase databases up to April 2018 and checked manually the bibliography of the original articles. The quality of the studies was evaluated using the Cochrane Risk of Bias Tool.

Results

This study analyzed 15 randomized, controlled trials involving 782 patients with NAFLD. Probiotics and synbiotics supplementation could significantly improve liver steatosis, alanine aminotransferase, aspartate aminotransferase, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein, homeostasis model assessment-insulin resistance, liver stiffness and tumor necrosis factor-alpha (all P < 0.05). But the supplementation could not ameliorate body mass index (mean difference [MD] = −0.00; 95% confidence interval [CI]: −0.22 to 0.22, P = 0.99), waist circumference (MD = −0.01; 95% CI −0.03 to 0.02, P = 0.57) and fasting blood sugar (standard mean difference [SMD] = −0.10; 95% CI −0.32 to 0.12, P = 0.39).

Conclusion

We present clear evidence for the benefit of probiotics and synbiotics supplementation for liver steatosis, liver enzymes, lipid profiles and liver stiffness in patients with NAFLD.

Keywords

Probiotics Synbiotics Nonalcoholic fatty liver disease Meta-analysis 
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Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10620_2019_5699_MOESM1_ESM.tif (370 kb)
Supplementary Fig. 1. Risk of bias summary: review authors’ judgements about each risk of bias item for each included study (TIFF 369 kb)
10620_2019_5699_MOESM2_ESM.tif (326 kb)
Supplementary Fig. 2. Risk of bias graph: review authors’ judgements about each risk of bias item presented as percentages across all included studies (TIFF 325 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of GraduateTianjin Medical UniversityTianjinChina
  2. 2.Department of HepatologyTianjin Second People’s HospitalTianjinChina
  3. 3.Tianjin Research Institute of Liver DiseasesTianjinChina

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