Chang Ko-Shih, Kuo Wu-Hsien, Chang Mu-Hsin, Hsiao Yao, Tsai Ru-Yin
Department of Cardiology, Yuan Rung Hospital, Yuanlin, Changhua 51045, Taiwan.
Department of Gastroenterology and Hepatology, Yuan Sheng Branch, Yuan-Rung Hospital, Changhua 51052, Taiwan.
Int J Mol Sci. 2025 Jun 20;26(13):5944. doi: 10.3390/ijms26135944.
Diseases, including cardiovascular disease, type II diabetes, and metabolic syndrome, are leading causes of morbidity and mortality worldwide. Non-alcoholic fatty liver disease (NAFLD) is commonly associated with these conditions through shared pathophysiological mechanisms such as insulin resistance, chronic inflammation, and dyslipidemia. Emerging evidence suggests that probiotic formulations containing Bifidobacterium species may support cardiometabolic health by modulating gut microbiota composition. This meta-analysis aimed to assess the efficacy of Bifidobacterium-containing probiotic combinations in improving key cardiometabolic parameters, including lipid profiles, blood pressure, glycemic indices, and inflammatory biomarkers among individuals with NAFLD. A systematic literature search was conducted across PubMed, Embase, the Cochrane Library, and Web of Science databases to identify relevant randomized controlled trials (RCTs) published up to December 2024. A total of 24 RCTs involving 1611 participants met the inclusion criteria. The pooled results demonstrated significant reductions in total cholesterol, triglycerides, and low-density lipoprotein cholesterol following probiotic intervention. Improvements were also observed in fasting glucose levels and inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6). Although modest improvements were noted in NAFLD severity, the effects on liver injury markers were relatively limited. These findings suggest that Bifidobacterium-based probiotic combinations may provide cardiometabolic benefits, particularly in lipid regulation, glucose metabolism, and inflammatory control. Further large-scale, well-designed RCTs are warranted to validate these results and to determine the most effective probiotic strains, compositions, and treatment durations.
包括心血管疾病、2型糖尿病和代谢综合征在内的疾病是全球发病和死亡的主要原因。非酒精性脂肪性肝病（NAFLD）通常通过胰岛素抵抗、慢性炎症和血脂异常等共同的病理生理机制与这些疾病相关联。新出现的证据表明，含有双歧杆菌属的益生菌制剂可能通过调节肠道微生物群组成来支持心脏代谢健康。这项荟萃分析旨在评估含双歧杆菌的益生菌组合在改善NAFLD患者关键心脏代谢参数方面的疗效，这些参数包括血脂谱、血压、血糖指数和炎症生物标志物。通过对PubMed、Embase、Cochrane图书馆和科学网数据库进行系统的文献检索，以识别截至2024年12月发表的相关随机对照试验（RCT）。共有24项涉及1611名参与者的RCT符合纳入标准。汇总结果显示，益生菌干预后总胆固醇、甘油三酯和低密度脂蛋白胆固醇显著降低。空腹血糖水平和炎症标志物也有改善，包括高敏C反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）。虽然NAFLD严重程度有适度改善，但对肝损伤标志物的影响相对有限。这些发现表明，基于双歧杆菌的益生菌组合可能提供心脏代谢益处，特别是在脂质调节、葡萄糖代谢和炎症控制方面。有必要进行进一步的大规模、精心设计的RCT来验证这些结果，并确定最有效的益生菌菌株、组成和治疗持续时间。
