Guizhou University of Traditional Chinese Medicine, Guiyang, China.
The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China.
Medicine (Baltimore). 2023 Jan 27;102(4):e32734. doi: 10.1097/MD.0000000000032734.
The intestinal flora is closely related to the pathogenesis of nonalcoholic fatty liver disease (NAFLD). This study intends to systematically evaluate the efficacy and safety of probiotics in the treatment of NAFLD through a meta-analysis of published randomized controlled trials.
This study was conducted through a search of published randomized controlled trials using probiotic-related drugs for the treatment of nonalcoholic fatty liver disease (up to April 6, 2022). The JADAD evaluation table was used to evaluate the quality of the literatures included in the search, and the risk of bias was evaluated according to the Cochrane evaluation manual. Finally, RevMan5.4 software was used for meta-analysis.
A total of 21 randomized clinical trials involving 1037 patients with NAFLD were included in this study. Meta-analysis results showed that after probiotic intervention, liver function, blood lipid level, blood glucose levels and insulin levels were significantly reduced, which had a good effect on improving hepatic steatosis. However, it did not significantly improve BMI, inflammatory factors, or homeostasis model assessment of insulin resistance. Through the subgroup analysis of the course of treatment, it was found that ALT, GGT, TG, and blood sugar improved better in the probiotic treatment course of greater than or equal to 12 weeks.
This study shows that the use of probiotics therapy has a good regulating effect on liver function, steatosis, blood glucose level, insulin level and blood lipid level in NAFLD patients.
肠道菌群与非酒精性脂肪性肝病(NAFLD)的发病机制密切相关。本研究旨在通过对已发表的随机对照试验进行荟萃分析,系统评价益生菌治疗 NAFLD 的疗效和安全性。
本研究通过检索已发表的使用益生菌相关药物治疗非酒精性脂肪性肝病的随机对照试验(截至 2022 年 4 月 6 日)。使用 Jadad 评价量表评价纳入研究的文献质量,并根据 Cochrane 评价手册评价偏倚风险。最后使用 RevMan5.4 软件进行荟萃分析。
本研究共纳入 21 项随机临床试验,涉及 1037 例 NAFLD 患者。Meta 分析结果显示,益生菌干预后肝功能、血脂水平、血糖水平和胰岛素水平显著降低,对改善肝脂肪变性有较好的效果。但对 BMI、炎症因子或胰岛素抵抗的稳态模型评估无明显改善。通过治疗疗程的亚组分析发现,益生菌治疗疗程大于或等于 12 周时,ALT、GGT、TG 和血糖改善更好。
本研究表明,益生菌疗法对 NAFLD 患者的肝功能、脂肪变性、血糖水平、胰岛素水平和血脂水平具有良好的调节作用。