Effects Of Probiotics On Nonalcoholic Fatty Liver Disease:a Meta-analysis

Objective:To investigate the relationship between the gut-liver axis and nonalcoholic fatty liver disease(NAFLD), we performed a meta-analysis to evaluate the effects of probiotic therapy in NAFLD.Methods:We searched PubMed, Medline, Embase, Web of Science, the Cochrane Library and Chinese Biomedicine Database for all relevant randomized controlled trials on probiotics in patients with NAFLD/non-alcoholic steatohepatitis (NASH). A statistical analysis was performed using RevMan5.0software.Results:The electronic searches yielded475items. After reviewing each publication, we selected4original studies involving134NAFLD/NASH patients. The results showed that probiotic therapy significantly decreased alanine aminotransferase(ALT), aspartate transaminase(AST), total-cholesterol(T-chol), high density lipoprotein(HDL), tumor necrosis factor(TNF)-a and homeostasis model assessment of insulin resistance(HOMA-IR)(ALT:WMD-23.71,95%CI:-33.46to-13.95, P<0.00001; AST:WMD-19.77,95%CI:-32.55to-7.00, P=0.002; T-chol:WMD-0.28,95%CI:-0.55to-0.01, P=0.04; HDL:WMD-0.09,95%CI:-0.16to0.01, P=0.03; TNF-a: WMD-0.32,95%CI:-0.48to-0.17, P<0.0001; HOMA-IR:WMD-0.46,95%CI:-0.73to-0.19,P=0.0008). However, the use of probiotics was not associated with changes in body mass index(BMI), glucose(GLU) and low density lipoprotein(LDL)(BMI:WMD 0.05,95%CI:-0.18to0.29, P=0.64; GLU:WMD0.05,95%CI:-0.25to0.35, P=0.76; LDL:WMD-0.38,95%CI:-0.78to0.02, P=0.06).Conclusions:Probiotic therapy can reduce liver aminotransferases, total-cholesterol, TNF-a and improve insulin resistance in NAFLD patients. Modulation of the gut microbiota represents a new treatment for NAFLD.