Effects of probiotics on nonalcoholic fatty liver disease: A meta-analysis

AIM: To investigate the relationship between the gutliver axis and nonalcoholic fatty liver disease (NAFLD), we performed a meta-analysis to evaluate the effects of probiotic therapy in NAFLD. METHODS: We searched PubMed, Medline, Embase, Web of Science, the Cochrane Library and Chinese Biomedicine Database for all relevant randomized controlled trials on probiotics in patients with NAFLD/non-alcoholic steatohepatitis (NASH). A statistical analysis was performed using RevMan 5.0 software. RESULTS: Four randomized trials involving 134 NAFLD/NASH patients were included. The results showed that probiotic therapy significantly decreased alanine aminotransferase (ALT), aspartate transaminase (AST), total-cholesterol (T-chol), high density lipoprotein (HDL), tumor necrosis factor (TNF)-alpha and homeostasis model assessment of insulin resistance (HOMAIR) [ALT: weighted mean difference (WMD) -23.71, 95%CI: -33.46-13.95, P < 0.00001; AST: WMD -19.77, 95%CI: -32.55-7.00, P = 0.002; T-chol: WMD -0.28, 95%CI: -0.55-0.01, P = 0.04; HDL: WMD -0.09, 95%CI: -0.16-0.01, P = 0.03; TNF-alpha: WMD -0.32, 95%CI: -0.48-0.17, P < 0.0001; HOMA-IR: WMD -0.46, 95%CI: -0.73-0.19, P = 0.0008]. However, the use of probiotics was not associated with changes in body mass index (BMI), glucose (GLU) and low density lipoprotein (LDL) (BMI: WMD 0.05, 95%CI: -0.18-0.29, P = 0.64; GLU: WMD 0.05, 95%CI: -0.25-0.35, P = 0.76; LDL: WMD -0.38, 95%CI: -0.78-0.02, P = 0.06). CONCLUSION: Probiotic therapies can reduce liver aminotransferases, total-cholesterol, TNF-a and improve insulin resistance in NAFLD patients. Modulation of the gut microbiota represents a new treatment for NAFLD. (C) 2013 Baishideng. All rights reserved.