Department of Public Health, School of Medicine, Nanjing University of Chinese Medicine, Nanjing, PR China.
Department of Diagnostics of Chinese Medicine, School of Chinese Medicine, School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, PR China.
Clin Res Hepatol Gastroenterol. 2024 Aug;48(7):102397. doi: 10.1016/j.clinre.2024.102397. Epub 2024 Jun 13.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is constantly rising globally. There are barely any effective medications or supplements for the management of MASLD. We aim to systematically evaluate the most current evidence for gut microbiota-regulating supplements in patients with MASLD.
We searched multiple electronic data for randomized controlled trials (RCTs) published from January 1, 2012, to July 15, 2023. The intervention measures included probiotics, prebiotics, synbiotics, antibiotics, and fecal microbiota transplantation (FMT). The control group was treated with a placebo or usual care. The intervention duration was divided into two periods (>12 weeks and ≤12 weeks). Adequate evaluation data for antibiotics and FMT have not been obtained. Therefore, the other three microbiota regulators are the primary evaluation measures in this study.
We found that probiotics alone could not improve clinical indicators in MASLD patients. However, synbiotics exhibited an improvement in reducing liver steatosis, TNF-ɑ levels, and increasing HDL-c levels, and the inflammatory markers of liver cells (ALT and AST) were also improved. For the effective intervention duration, this systematic review suggested that around 12 weeks is an ideal intervention cycle for MASLD patients.
This meta-analysis supported the modulation of gut microbiota with synbiotics in the management of MASLD.
代谢相关脂肪性肝病（MASLD）在全球范围内不断增加。目前针对 MASLD 的管理，几乎没有有效的药物或补充剂。我们旨在系统评估调节肠道微生物组的补充剂在 MASLD 患者中的最新证据。
我们搜索了多个电子数据库，以获取自 2012 年 1 月 1 日至 2023 年 7 月 15 日发表的随机对照试验（RCT）。干预措施包括益生菌、益生元、合生元、抗生素和粪便微生物群移植（FMT）。对照组接受安慰剂或常规治疗。干预持续时间分为两个时期（>12 周和≤12 周）。尚未获得足够的抗生素和 FMT 评估数据。因此，本研究的主要评估措施是其他三种微生物组调节剂。
我们发现单独使用益生菌不能改善 MASLD 患者的临床指标。然而，合生元在改善肝脂肪变性、TNF-ɑ 水平和增加 HDL-c 水平方面表现出改善作用，肝细胞的炎症标志物（ALT 和 AST）也得到改善。对于有效干预持续时间，本系统评价表明，大约 12 周是 MASLD 患者的理想干预周期。
这项荟萃分析支持使用合生元调节肠道微生物组来管理 MASLD。
