Cosier Denelle J, Lambert Kelly, Neale Elizabeth P, Probst Yasmine, Charlton Karen
School of Medicine, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia.
Nutr Rev. 2025 Feb 1;83(2):e4-e24. doi: 10.1093/nutrit/nuae002.
Prior research has explored the effect of synbiotics, the combination of probiotics and prebiotics, on the gut microbiota in clinical populations. However, evidence related to the effect of synbiotics on the gut microbiota in healthy adults has not been reviewed to date.
A systematic review and meta-analysis was conducted to comprehensively investigate the effect of synbiotics on the gut microbiota and inflammatory markers in populations of healthy adults.
Scopus, PubMed, Web of Science, ScienceDirect, MEDLINE, CINAHL, and The Cochrane Library were systematically searched to retrieve randomized controlled trials examining the primary outcome of gut microbiota or intestinal permeability changes after synbiotic consumption in healthy adults. Secondary outcomes of interest were short-chain fatty acids, inflammatory biomarkers, and gut microbiota diversity.
Weighted (WMD) or standardized mean difference (SMD) outcome data were pooled in restricted maximum likelihood models using random effects. Twenty-seven articles reporting on 26 studies met the eligibility criteria (n = 1319).
Meta-analyses of 16 studies showed synbiotics resulted in a significant increase in Lactobacillus cell count (SMD, 0.74; 95% confidence interval [CI], 0.15, 1.33; P = 0.01) and propionate concentration (SMD, 0.22; 95% CI, 0.02, 0.43; P = 0.03) compared with controls. A trend for an increase in Bifidobacterium relative abundance (WMD, 0.97; 95% CI, 0.42, 2.52; P = 0.10) and cell count (SMD, 0.82; 95% CI, 0.13, 1.88; P = 0.06) was seen. No significant differences in α-diversity, acetate, butyrate, zonulin, IL-6, CRP, or endotoxins were observed.
This review demonstrates that synbiotics modulate the gut microbiota by increasing Lactobacillus and propionate across various healthy adult populations, and may result in increased Bifidobacterium. Significant variations in synbiotic type, dose, and duration should be considered as limitations when applying findings to clinical practice.
PROSPERO no. CRD42021284033.
先前的研究探讨了合生元（益生菌和益生元的组合）对临床人群肠道微生物群的影响。然而，迄今为止，尚未对合生元对健康成年人肠道微生物群影响的相关证据进行综述。
进行一项系统评价和荟萃分析，以全面研究合生元对健康成年人群肠道微生物群和炎症标志物的影响。
对Scopus、PubMed、科学网、ScienceDirect、MEDLINE、CINAHL和考克兰图书馆进行系统检索，以获取随机对照试验，这些试验研究了健康成年人食用合生元后肠道微生物群或肠道通透性变化的主要结局。感兴趣的次要结局为短链脂肪酸、炎症生物标志物和肠道微生物群多样性。
使用随机效应，在受限最大似然模型中汇总加权均数差（WMD）或标准化均数差（SMD）结局数据。27篇报道26项研究的文章符合纳入标准（n = 1319）。
16项研究的荟萃分析表明，与对照组相比，合生元使乳酸杆菌细胞计数显著增加（SMD，0.74；95%置信区间[CI]，0.15，1.33；P = 0.01）和丙酸盐浓度显著增加（SMD，0.22；95%CI，0.02，0.43；P = 0.03）。观察到双歧杆菌相对丰度（WMD，0.97；95%CI，0.42，2.52；P = 0.10）和细胞计数（SMD，0.82；95%CI，0.13，1.88；P = 0.06）有增加趋势。未观察到α多样性、乙酸盐、丁酸盐、闭合蛋白、白细胞介素-6、C反应蛋白或内毒素有显著差异。
本综述表明，合生元通过增加不同健康成年人群中的乳酸杆菌和丙酸盐来调节肠道微生物群，并可能导致双歧杆菌增加。在将研究结果应用于临床实践时，应将合生元类型、剂量和持续时间的显著差异视为局限性。
PROSPERO编号CRD42021284033。
