Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, China.
Int J Obes (Lond). 2023 Nov;47(11):1029-1042. doi: 10.1038/s41366-023-01375-5. Epub 2023 Sep 6.
Probiotics are commonly used after bariatric surgery. However, uncertainty remains regarding their effects. The purpose of this systematic review was to assess the effect of probiotics in patients with morbid obesity undergoing bariatric surgery.
PubMed, Cochrane Library, Embase, Science Direct, and Web of Science were searched from inception to April 4, 2023. No language restrictions were applied. Relevant randomized controlled trials and controlled clinical trials were included. We used the aggregated data extracted from the trials and assessed the heterogeneity. When severe heterogeneity was detected, a random effect model was used. All stages of the review were done by independent authors.
We screened 2024 references and included 11 randomized controlled trials and controlled clinical trials. Compared with the protocol groups, probiotics showed significant effects on regulating aspartate amino transferase level (MD = -4.32 U/L; 95% CI [-7.10, -1.53], p = 0.002), triglycerides (MD = -20.16 mg/dL; 95% CI [-34.51, -5.82], p = 0.006), weight (MD = -1.99 kg; 95% CI [-3.97, -0.01], p = 0.05), vitamin B (MD = 2.24 pg/dL; 95% CI [-0.02, 4.51], p = 0.05), dietary energy (MD = -151.03 kcal; 95% CI [-215.68, -86.37], p < 0.00001), dietary protein (MD = -4.48 g/day, 95% CI [-8.76, -0.20], p = 0.04), dietary carbohydrate (MD = -34.25 g/day, 95% CI [-44.87, -23.62], p < 0.00001), and dietary fiber (MD = -2.17 g/day, 95% CI [-3.21, -1.14], p < 0.0001). There were no severe side effects related to probiotics.
Our meta-analysis suggested that probiotics may delay the progression of liver function injury, improve lipid metabolism, reduce weight, and reduce food intake, although the effects on other indicators were insignificant. Probiotics may be helpful for patients undergoing bariatric surgery. The review was registered on PROSPERO (International prospective register of systematic reviews): CRD42023407970. No primary source of funding.
益生菌常用于减重手术后。然而，其效果仍存在不确定性。本系统评价的目的是评估益生菌对接受减重手术的病态肥胖患者的影响。
从建库到 2023 年 4 月 4 日，检索了 PubMed、Cochrane 图书馆、Embase、Science Direct 和 Web of Science，未对语言进行限制。纳入了随机对照试验和对照临床试验。我们使用从试验中提取的汇总数据，并评估了异质性。当检测到严重异质性时，使用随机效应模型。所有阶段的综述均由独立作者完成。
我们筛选了 2024 篇参考文献，纳入了 11 项随机对照试验和对照临床试验。与方案组相比，益生菌对调节天冬氨酸氨基转移酶水平（MD=-4.32U/L；95%CI[-7.10，-1.53]，p=0.002）、甘油三酯（MD=-20.16mg/dL；95%CI[-34.51，-5.82]，p=0.006）、体重（MD=-1.99kg；95%CI[-3.97，-0.01]，p=0.05）、维生素 B（MD=2.24pg/dL；95%CI[0.02，4.51]，p=0.05）、膳食能量（MD=-151.03kcal；95%CI[-215.68，-86.37]，p<0.00001）、膳食蛋白质（MD=-4.48g/d，95%CI[-8.76，-0.20]，p=0.04）、膳食碳水化合物（MD=-34.25g/d，95%CI[-44.87，-23.62]，p<0.00001）和膳食纤维（MD=-2.17g/d，95%CI[-3.21，-1.14]，p<0.0001）均有显著影响。益生菌无严重相关副作用。
我们的荟萃分析表明，益生菌可能延缓肝功能损伤的进展，改善脂质代谢，减轻体重，减少食物摄入，尽管对其他指标的影响不显著。益生菌可能有助于接受减重手术的患者。本综述已在 PROSPERO（国际前瞻性系统评价注册库）上注册：CRD42023407970。无主要资金来源。
