Ramezani Ahmadi Amirhossein, Sadeghian Mehdi, Alipour Meysam, Ahmadi Taheri Samira, Rahmani Sepideh, Abbasnezhad Amir
Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Clinical Research Development Unit, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Iran J Public Health. 2020 Jul;49(7):1222-1231. doi: 10.18502/ijph.v49i7.3575.
This systematic review and meta-analysis was conducted to obtain a conclusive result on the influence of probiotics/synbiotic on serum levels of zonulin. Data related to serum levels of zonulin were extracted to determine the effects of probiotic/synbiotic on intestinal permeability.
The literature search was conducted across the Cochrane Central Register of Controlled Trials, Pub-Med, Scopus and ISI Web of Science, Search up to Nov 2018. Clinical trials evaluating the effect of probiotic/synbiotic on serum zonulin levels of all human subjects were included.
Nine studies (including 496 intervention and 443 control subjects) met the inclusion criteria for the meta-analysis. According to the meta-analysis, probiotic/synbiotic has a significant effect on serum zonulin reduction (WMD=-10.55 [95% CI: -17.76, -3.34]; =0.004). However, the high level of heterogeneity was observed among the studies (I=97.8, <0.001). The subgroup analysis suggested study quality, blinding, study duration, Participants age, subject's health status and supplement type as sources of heterogeneity.
Probiotic/synbiotic have favorable effects on serum levels of zonulin as a measure of intestinal permeability. However, the results should be interpreted with caution due to the high heterogeneity and further evidence is required before definitive recommendations can be made.
本系统评价和荟萃分析旨在得出关于益生菌/合生元对血清中闭合蛋白水平影响的确切结果。提取与血清闭合蛋白水平相关的数据，以确定益生菌/合生元对肠道通透性的影响。
检索Cochrane对照试验中央注册库、PubMed、Scopus和ISI科学网，检索截至2018年11月的文献。纳入评估益生菌/合生元对所有人类受试者血清闭合蛋白水平影响的临床试验。
9项研究（包括496名干预组和443名对照组受试者）符合荟萃分析的纳入标准。根据荟萃分析，益生菌/合生元对降低血清闭合蛋白水平有显著作用（加权均数差=-10.55[95%置信区间：-17.76，-3.34]；P=0.004）。然而，各研究间观察到高度异质性（I²=97.8，P<0.001）。亚组分析表明研究质量、盲法、研究持续时间、参与者年龄、受试者健康状况和补充剂类型是异质性来源。
益生菌/合生元作为衡量肠道通透性的指标，对血清闭合蛋白水平有有益影响。然而，由于高度异质性，结果应谨慎解释，在做出明确推荐之前还需要进一步的证据。
