Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Probiotics Antimicrob Proteins. 2024 Dec;16(6):2316-2328. doi: 10.1007/s12602-024-10363-8. Epub 2024 Sep 25.
Numerous primary and secondary studies have consistently demonstrated that probiotics, including lactobacillus and Bifidobacterium, possess a potential anti-obesity effect. However, it is worth noting that some studies have yielded contrasting results. Considering this, our study aims to present a comprehensive overview of published systematic reviews and meta-analyses, focusing on the efficacy and safety of probiotics in managing obesity. To achieve this objective, we conducted an umbrella review following the PRISMA protocol and Cochrane guidelines. We searched databases such as Embase, PubMed, Cochrane Library, and Google Scholar for relevant systematic reviews and meta-analyses published in English, without imposing any date restrictions. Our inclusion criteria encompassed studies evaluating the anti-obesity impact of probiotics, with a specific focus on changes in body mass index (BMI), fat mass percentage (FMP), body weight (BW), and body fat mass (BFM). These studies were meticulously reviewed by two independent reviewers. Our analysis included five systematic reviews and 18 meta-analyses that met the predefined inclusion and exclusion criteria. The meta-analyses revealed statistically significant reductions in the following parameters: BMI, a decrease of 0.30 kg/m (p < 0.00001, 95% CI - 0.36 to - 0.25); BFM, a reduction of 0.86 kg (p < 0.00001, 95% CI - 1.02 to - 0.71); BW, a decrease of 0.59 kg (p < 0.00001, 95% CI - 0.74 to - 0.44); and FMP, a substantial decline of 78% (p < 0.00001, 95% CI - 1.02 to - 0.54). In summary, our umbrella review suggests that existing evidence supports the potential benefits of probiotics in managing obesity and overweight. However, it is essential to acknowledge that the credibility of this evidence is somewhat limited due to the inclusion of studies with poor-quality designs and relatively small participant numbers. To establish the true efficacy of probiotics in obesity management, we recommend conducting robust studies involving larger participant cohorts.
大量的基础研究和二级研究一致表明，益生菌，包括乳杆菌和双歧杆菌，具有潜在的抗肥胖作用。然而，值得注意的是，一些研究得出了相反的结果。考虑到这一点，我们的研究旨在对已发表的系统评价和荟萃分析进行全面综述，重点关注益生菌在肥胖管理中的疗效和安全性。为了实现这一目标，我们按照 PRISMA 方案和 Cochrane 指南进行了伞式综述。我们在 Embase、PubMed、Cochrane 图书馆和 Google Scholar 等数据库中搜索了以英文发表的相关系统评价和荟萃分析，没有设置任何日期限制。我们的纳入标准包括评估益生菌抗肥胖影响的研究，特别关注体重指数 (BMI)、体脂肪百分比 (FMP)、体重 (BW) 和体脂肪量 (BFM) 的变化。这些研究由两名独立的评审员仔细审查。我们的分析包括 5 项系统评价和 18 项符合预设纳入和排除标准的荟萃分析。荟萃分析显示以下参数有统计学意义的降低：BMI，减少 0.30kg/m（p<0.00001，95%CI-0.36 至-0.25）；BFM，减少 0.86kg（p<0.00001，95%CI-1.02 至-0.71）；BW，减少 0.59kg（p<0.00001，95%CI-0.74 至-0.44）；FMP，显著下降 78%（p<0.00001，95%CI-1.02 至-0.54）。总之，我们的伞式综述表明，现有证据支持益生菌在肥胖和超重管理中的潜在益处。然而，必须承认，由于纳入了设计质量较差且参与者数量相对较少的研究，因此该证据的可信度有些有限。为了确定益生菌在肥胖管理中的真实疗效，我们建议进行涉及更大参与者队列的强有力研究。
