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益生菌对非酒精性脂肪性肝病的影响:系统评价和荟萃分析。

Effects of probiotics on nonalcoholic fatty liver disease: a systematic review and meta-analysis.

机构信息

Department of Postgraduates, Nanjing University of Chinese Medicine, Nanjing, China.

Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China.

出版信息

Expert Rev Gastroenterol Hepatol. 2021 Dec;15(12):1401-1409. doi: 10.1080/17474124.2022.2016391.

Abstract

OBJECTIVES

Several studies have suggested that the gut-liver axis is closely related to nonalcoholic fatty liver disease (NAFLD). This study was designed to conduct a meta-analysis based on a randomized controlled trial (RCT) to systematically evaluate the efficacy of probiotics in the treatment of NAFLD.

METHODS

This study carried out a literature search of published scientific data (up to April 2021) on probiotic therapies of NAFLD. The quality of the included literature was evaluated, and the corresponding data were extracted using the RevMan5.4 software.

RESULTS

A total of 9 randomized clinical trials involving 352 patients with NAFLD were included in this study. Results of the meta-analysisstudy showed that probiotic therapy group have significant reduction in the levels of serum indices: alanine aminotransferase (ALT), aspartate transaminase (AST) and total cholesterol (TC) in comparison with the control group. Probiotic therapy was not associated with changes in body mass index (BMI) homeostasis model assessment of insulin resistance (HOMA-IR) and tumor necrosis factor (TNF) Subgroup analyses of BMI indicated that three or more composite probiotics or probiotic treatment for more than three months can significantly reduce the BMI level.

CONCLUSION

This systematic review and meta-analysis demonstrated that modulating gut microbiota may be utilized as an effective method to improve liver function and reduce blood lipid levels in patients with NAFLD.

摘要

目的

多项研究表明,肠-肝轴与非酒精性脂肪性肝病(NAFLD)密切相关。本研究旨在通过随机对照试验(RCT)进行荟萃分析,系统评估益生菌治疗 NAFLD 的疗效。

方法

本研究对已发表的 NAFLD 益生菌治疗科学数据(截至 2021 年 4 月)进行了文献检索。使用 RevMan5.4 软件评估纳入文献的质量,并提取相应数据。

结果

本研究共纳入 9 项涉及 352 例 NAFLD 患者的随机临床试验。荟萃分析结果表明,与对照组相比,益生菌治疗组患者的血清指标丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和总胆固醇(TC)水平显著降低。益生菌治疗与体重指数(BMI)、胰岛素抵抗稳态模型评估(HOMA-IR)和肿瘤坏死因子(TNF)变化无关。BMI 的亚组分析表明,三种或更多种复合益生菌或益生菌治疗超过三个月可以显著降低 BMI 水平。

结论

本系统评价和荟萃分析表明,调节肠道微生物群可能是改善 NAFLD 患者肝功能和降低血脂水平的有效方法。

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