Chen Yaqin, Peng Yanchun, Niu Qi, Jiang Yan, Ni Hong, Chen Liangwan, Lin Yanjuan
School of Nursing, Fujian Medical University, Fuzhou, Fujian, China.
Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Eur J Pharmacol. 2025 May 5;994:177326. doi: 10.1016/j.ejphar.2025.177326. Epub 2025 Feb 4.
While existing meta-analysis suggest that probiotic therapies may enhance cognitive functions and influence metabolic characteristics, the findings have been inconclusive. In light of these discrepancies, our study undertakes an umbrella review to more precisely determine the aggregate effects and rigorously evaluate the credibility and quality of evidence.
We conducted a systematic search across seven databases, including PubMed, Embase, the Cochrane Library, ProQuest, Web of Science, CINAHL, and Scopus, from their inception to June 20, 2024. We utilized the AMSTAR-2 tool to evaluate the quality of the meta-analyses and applied the GRADE system to rate the quality of the evidence. We estimated the final effect sizes (ESs) along with their 95% confidence intervals (CI) and performed both sensitivity and subgroup analyses to explore the sources of heterogeneity.
Among the 314 articles identified in our search, 13 meta-analysis that met the criteria were included in the study. The quality of the evidence in these studies was graded from high to very low. Our results demonstrate that probiotic treatment significantly enhances cognitive function in patients (ES = 0.39, 95%CI: 0.19 to 0.59, p < 0.001). Moreover, probiotic treatment notably decreased level of serum malondialdehyde (MDA), insulin resistance as detected by homeostasis model assessment method (HOMA-IR) and high-sensitivity C-reactive protein (hs-CRP) (p < 0.001). Conversely, probiotic treatment did not significantly impact triglycerides and very-low-density lipoprotein (VLDL) in patients (p > 0.05).
Although preliminary evidence indicated that probiotic therapy may positively impact cognitive function, MDA, HOMA-IR, and hs-CRP, the overall quality of the existing evidence is insufficient to provide strong support. Therefore, future research must employ more rigorous designs or initiate larger clinical trials to produce more compelling evidence to further validate the efficacy of probiotic therapy on cognitive function of patients with cognitive dysfunction.
虽然现有的荟萃分析表明益生菌疗法可能增强认知功能并影响代谢特征，但研究结果尚无定论。鉴于这些差异，我们的研究进行了一项综合评价，以更精确地确定总体效应，并严格评估证据的可信度和质量。
我们对包括PubMed、Embase、Cochrane图书馆、ProQuest、Web of Science、CINAHL和Scopus在内的七个数据库进行了系统检索，检索时间从各数据库建库至2024年6月20日。我们使用AMSTAR-2工具评估荟萃分析的质量，并应用GRADE系统对证据质量进行评级。我们估计了最终效应大小（ESs）及其95%置信区间（CI），并进行了敏感性分析和亚组分析以探索异质性来源。
在我们检索到的314篇文章中，有13项符合标准的荟萃分析被纳入研究。这些研究中的证据质量从高到极低不等。我们的结果表明，益生菌治疗可显著增强患者的认知功能（ES = 0.39，95%CI：0.19至0.59，p < 0.001）。此外，益生菌治疗显著降低了血清丙二醛（MDA）水平、采用稳态模型评估法（HOMA-IR）检测的胰岛素抵抗以及高敏C反应蛋白（hs-CRP）水平（p < 0.001）。相反，益生菌治疗对患者的甘油三酯和极低密度脂蛋白（VLDL）没有显著影响（p > 0.05）。
虽然初步证据表明益生菌疗法可能对认知功能、MDA、HOMA-IR和hs-CRP产生积极影响，但现有证据的总体质量不足以提供有力支持。因此，未来的研究必须采用更严谨的设计或开展更大规模的临床试验，以产生更有说服力的证据，进一步验证益生菌疗法对认知功能障碍患者认知功能的疗效。
