Lu Jing, Dong Xiaoxiao, Gao Ziqi, Yan Huizhen, Shataer Dilireba, Wang Liang, Qin Yanan, Zhang Minwei, Wang Jiayi, Cui Jie, Zhou Shengyang
College of Smart Agriculture (Research Institute), Xinjiang University, Urumqi, 830046, China.
College of Food Science and Light Industry, Nanjing Tech University, Nanjing, 211816, China.
Curr Res Food Sci. 2025 Jul 8;11:101138. doi: 10.1016/j.crfs.2025.101138. eCollection 2025.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is recognized as one of the most common chronic liver conditions globally, presenting a significant public health. Probiotics, as modulators of intestinal microbiota, have emerged attention as a potential therapeutic strategy for managing MASLD. This systematic review and meta-analysis encompassed 12 randomized controlled trials including 657 participants to quantify the effects of probiotic supplementation on liver function indicators, lipid metabolism, and inflammatory markers in MASLD patients. Compared with placebo, probiotics significantly reduced liver-related measures, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γ-glutamyl transaminase (GGT) levels (MD: 8.12 IU/L, MD: 7.98 IU/L, MD: 6.43IU/L). Meanwhile, probiotics also demonstrated significantly reduction in triglyceride (TG) and total cholesterol (TC) levels (MD: 9.35 mg/dL, MD: 7.91 mg/dL). Furthermore, probiotics significantly increased high-density lipoprotein cholesterol (HDL-C) levels (MD: 3.31 mg/dL) and decreased low-density lipoprotein cholesterol (LDL-C) levels (MD: 6.31 mg/dL). Given the substantial heterogeneity observed in certain indicators (ALT, AST, TG, HDL-C), a subgroup analysis was conducted. Subgroup analysis revealed that these improvements were more pronounced in adults, though heterogeneity was higher compared to children, indicating more consistent effects in pediatric populations. This study further confirmed the potential value of probiotics in improving liver function and lipid metabolism in patients with MASLD by a rigorous meta-analysis that excluded the influence of potential interfering factors, such as regional factors and publication time. This study provides a better understanding of the individual differences in the effects of probiotic treatment and a solid theoretical basis for the development of relevant intervention products.
代谢功能障碍相关脂肪性肝病（MASLD）被认为是全球最常见的慢性肝脏疾病之一，对公众健康构成重大威胁。益生菌作为肠道微生物群的调节剂，已成为管理MASLD的一种潜在治疗策略并受到关注。本系统评价和荟萃分析纳入了12项随机对照试验，共657名参与者，以量化补充益生菌对MASLD患者肝功能指标、脂质代谢和炎症标志物的影响。与安慰剂相比，益生菌显著降低了肝脏相关指标，包括丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）和γ-谷氨酰转移酶（GGT）水平（MD：8.12 IU/L，MD：7.98 IU/L，MD：6.43 IU/L）。同时，益生菌还显著降低了甘油三酯（TG）和总胆固醇（TC）水平（MD：9.35 mg/dL，MD：7.91 mg/dL）。此外，益生菌显著提高了高密度脂蛋白胆固醇（HDL-C）水平（MD：3.31 mg/dL）并降低了低密度脂蛋白胆固醇（LDL-C）水平（MD：6.31 mg/dL）。鉴于在某些指标（ALT、AST、TG、HDL-C）中观察到显著的异质性，进行了亚组分析。亚组分析显示，这些改善在成年人中更为明显，尽管与儿童相比异质性更高，表明在儿科人群中的效果更一致。本研究通过严格的荟萃分析进一步证实了益生菌在改善MASLD患者肝功能和脂质代谢方面的潜在价值，该分析排除了潜在干扰因素（如地区因素和发表时间）的影响。本研究为更好地理解益生菌治疗效果的个体差异以及开发相关干预产品提供了坚实的理论基础。
