Anti-inflammatory effects of probiotics and synbiotics on patients with non-alcoholic fatty liver disease: An umbrella study on meta-analyses

The impact of chronic low-grade inflammation in the development of non-alcoholic fatty liver disease (NAFLD) has been studied widely. Previous studies showed gut pathogens' effects on inflammation development in NAFLD patients; hence, hypothetically, gut microbial therapy by administration of p...

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Published in:Clinical nutrition ESPEN 2023-10, Vol.57, p.475-486
Main Authors: Mahapatro, Abinash, Bawna, Fnu, Kumar, Vikash, Daryagasht, Amir Ali, Gupta, Siddharth, Raghuma, Nakka, Moghdam, Saman Soltani, Kolla, Akshita, Mahapatra, Shruti Sagar, Sattari, Nazila, Amini-Salehi, Ehsan, Nayak, Sandeep S.
Format: Article
Language:English
Subjects:
blood serum
C-reactive protein
clinical nutrition
digestive system
fatty liver
Gut microbiota
inflammation
intestinal microorganisms
Meta-analysis
Nonalcoholic fatty liver
prebiotics
probiotics
statistical models
therapeutics
Tumor necrosis factor-a
tumor necrosis factor-alpha
Umbrella review
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Summary:The impact of chronic low-grade inflammation in the development of non-alcoholic fatty liver disease (NAFLD) has been studied widely. Previous studies showed gut pathogens' effects on inflammation development in NAFLD patients; hence, hypothetically, gut microbial therapy by administration of probiotics, synbiotics, and prebiotics may alleviate inflammation in these individuals. Several studies were performed in this regard; however, conflicting results were obtained. In this study, we aimed to comprehensively evaluate the effects of gut microbial therapy on inflammatory markers in NAFLD patients in a meta-umbrella design. Two independent researchers investigated international databases, including PubMed, Web of Science, Scopus, and Cochrane Library, from inception until March 2023. Meta-analyses evaluating the impact of probiotics, synbiotics, or prebiotics on inflammatory markers of patients with NAFLD were eligible for our study. AMASTAR 2 checklist was used to evaluate the quality of included studies. Random effect model was performed for the analysis, and Egger's regression test was conducted to determine publication bias. A total number of 12 studies were entered into our analysis. Our findings revealed that gut microbial therapy could significantly reduce serum C-reactive protein (CRP) levels among NAFLD patients (ES: −0.58; 95% CI: −0.73, −0.44, P 
ISSN:2405-4577
2405-4577
DOI:10.1016/j.clnesp.2023.07.087