Efficacy of probiotics in non-alcoholic fatty liver disease in adult and children: A meta-analysis of randomized controlled trials

Aim: To evaluate the efficacy of probiotics in the treatment of adult and childhood non-alcoholic fatty liver disease (NAFLD). Methods: Randomized controlled trials on the efficacy of probiotics in the treatment of adult and childhood NAFLD published before July 2015 were searched in multiple databases, including Cochrane Library, PubMed/MEDLINE, EBSCO, OVID, SCI, CNKI, and VIP. Article identification and data extraction were carried out by two reviewers based on the inclusion and exclusion criteria. RevMan 5.3 software was used for the meta-analysis. Results: Nine randomized controlled trials with a total of 535 cases of NAFLD were included. Statistical differences in homeostasis model assessment, total cholesterol, high density lipoprotein, triglyceride, and tumor necrosis factor-a were detected between the probiotics and control groups with variations in different patient populations. No significant differences in body mass index (BMI), glucose, or insulin were detected between the two groups. Statistical differences in low density lipoprotein, alanine aminotransferase, aspartate transaminase, and BMI were detected between the two childhood groups (P = 0.05). Conclusion: Probiotics provided improvements in the outcomes of homeostasis model assessment, total cholesterol, high density lipoprotein, and tumor necrosis factor-a in any NAFLD patients and triglyceride in Italian and Spanish patients, but no improvement in the outcomes of BMI, glucose, or insulin in adult NAFLD patients. The currently available data are not sufficient to compare the effects of probiotics between adult and childhood NAFLD patients.