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益生菌在非酒精性脂肪性肝病治疗中的作用:一项荟萃分析。

Role of Probiotics in the Treatment of Nonalcoholic Fatty Liver Disease: A Meta-analysis.

作者信息

S Lavekar Anurag, V Raje Dhananjay, Manohar Tanuja, A Lavekar Amarja

机构信息

Department of Gastroenterology and Hepatology, JSS Hospital, Mysuru, Karnataka, India.

Department of Data Analysis Group, MDS Bio-Analytics Private Limited, Nagpur, Maharashtra, India.

出版信息

Euroasian J Hepatogastroenterol. 2017 Jul-Dec;7(2):130-137. doi: 10.5005/jp-journals-10018-1233. Epub 2017 Sep 29.

Abstract

AIM

Despite extensive ongoing research, there is scarcity of widely accepted therapeutic options for the treatment of nonalcoholic fatty liver disease (NAFLD). Probiotics are a promising treatment option for treating NAFLD; however, their effectiveness needs to be established. Since any single randomized controlled trial (RCT) cannot establish the role of probiotics in the treatment of NAFLD, this study aims at meta-analysis of different RCTs.

MATERIALS AND METHODS

Extensive search was done by two independent observers for RCTs studying the role of probiotics in the treatment of NAFLD. The parameters under consideration were body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), homeostatic model assessment of insulin resistance (HOMA-IR), serum triglycerides (TGs), and ultrasonographic grades of fatty liver. Jadad scale was used to select the articles for meta-analysis. Heterogeneity in the results was evaluated using chi-square test and . Significant heterogeneity in the results was decided based on p-value < 0.05 and the corresponding close to 0%.

RESULTS

Seven studies qualified for meta-analysis. Use of probiotics significantly caused reduction in BMI (p < 0.0001), ALT (p < 0.0001), AST (< 0.0001), HOMA-IR (p = 0.006), and ultrasonographic grade of fatty liver (p = 0.0051). Heterogeneity in other parameters was contributed mainly by couple of previous studies.

CONCLUSION

Meta-analysis shows that variety of parameters has significant improvement after probiotic treatment in different RCTs. However, the magnitude of improvement is not uniform across studies due to varying strains, dose patterns, and treatment duration. In future, probiotics remain a promising option for treating NAFLD. Lavekar AS, Raje DV, Manohar T, Lavekar AA. Role of Probiotics in the Treatment of Nonalcoholic Fatty Liver Disease: A Meta-analysis. Euroasian J Hepato-Gastroenterol 2017;7(2):130-137.

摘要

目的

尽管目前正在进行广泛的研究,但对于非酒精性脂肪性肝病(NAFLD)的治疗,仍缺乏广泛认可的治疗方案。益生菌是治疗NAFLD的一种有前景的治疗选择;然而,其有效性尚需确定。由于任何单个随机对照试验(RCT)都无法确定益生菌在NAFLD治疗中的作用,本研究旨在对不同的RCT进行荟萃分析。

材料与方法

由两名独立观察者广泛检索研究益生菌在NAFLD治疗中作用的RCT。所考虑的参数包括体重指数(BMI)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、胰岛素抵抗稳态模型评估(HOMA-IR)、血清甘油三酯(TGs)以及肝脏脂肪的超声分级。采用Jadad量表选择用于荟萃分析的文章。使用卡方检验和 评估结果的异质性。根据p值<0.05和相应的 接近0%来判定结果存在显著异质性。

结果

七项研究符合荟萃分析的条件。使用益生菌显著降低了BMI(p<0.0001)、ALT(p<0.0001)、AST(<0.0001)、HOMA-IR(p = 0.006)以及肝脏脂肪的超声分级(p = 0.0051)。其他参数的异质性主要由之前的几项研究造成。

结论

荟萃分析表明,在不同的RCT中,益生菌治疗后多种参数有显著改善。然而,由于菌株、剂量模式和治疗持续时间的不同,各研究中改善的程度并不一致。未来,益生菌仍是治疗NAFLD的一个有前景的选择。拉韦卡尔AS、拉杰DV、马诺哈尔T、拉韦卡尔AA。益生菌在非酒精性脂肪性肝病治疗中的作用:一项荟萃分析。《欧亚肝脏胃肠病学杂志》2017年;7(2):130 - 137。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd6f/5670255/fd11dc626f3a/ejohg-07-130-g001.jpg

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