Long term Probiotics use helpful for treating nonalcoholic fatty liver disease

The findings suggest the feasibility of probiotics for treating NAFLD. Several strains of Bifidobacterium and Lactobacillus can compete with and displace pathogenic bacteria. Therefore, probiotics may improve microbial composition and intestinal ecology, compete with and replace pathogenic bacteria, and prevent the overgrowth of small intestinal bacteria.

Nonalcoholic fatty liver disease is a common chronic liver disease caused by drug-induced or nonalcoholic fatty deposition in the liver and hepatocyte steatosis. In the initial stage, there are no apparent symptoms of the disease. In the absence of timely intervention, the condition can progress to nonalcoholic liver fibrosis, nonalcoholic steatohepatitis, and even liver cancer and liver cirrhosis in the later stage.

With the increasing incidence of NAFLD, it is crucial to find therapeutic methods to reduce the progression and occurrence of NAFLD, the authors noted. Considering intestinal flora is closely related to NAFLD pathogenesis, Sufang Zhou and associates from China aimed to systematically evaluate the safety and efficacy of probiotics in treating NAFLD through a meta-analysis of published randomized controlled trials (RCTs).

For this purpose, they searched for published RCTs using probiotic-related drugs for treating nonalcoholic fatty liver disease. A total of 21 randomized clinical trials comprising 1037 patients with NAFLD were included in the study. To evaluate the quality of included literature, the JADAD evaluation table was used. RevMan5.4 software was used for meta-analysis.

The study led to the following findings:

• Meta-analysis results showed that liver function, blood lipid level, blood glucose levels and insulin levels were significantly reduced after the probiotic intervention, which improved hepatic steatosis. However, it did not significantly improve BMI, inflammatory factors, or (HOMA-IR) homeostasis model assessment of insulin resistance.
• The subgroup analysis of the treatment course showed that GGT, ALT, TG, and blood sugar improved in the probiotic treatment course by greater than or equal to 12 weeks.

"In the study, we found that when the course of probiotics was longer than 12 weeks, the improvement of GGT, ALT, TG, blood sugar and blood sugar was better," the researchers wrote. "This finding provides a scientific basis for probiotics as a long-term intervention in treating NALFD. And less than 12 weeks is more effective for reducing BMI."

"There is a need for further well-designed prospective clinical studies incorporating preclinical models to identify pathogenic microorganism-host interactions in the NAFLD's development and pathogenesis," they conclude.

Reference:

Zhou, Xiangyu MSa,b; Wang, Jincheng MSa,b; Zhou, Sufang PhDb,*; Liao, Jiajia MSa,b; Ye, Zuoyu MSa,c; Mao, Leiming MSa,b. Efficacy of probiotics on nonalcoholic fatty liver disease: A meta-analysis. Medicine 102(4):p e32734, January 27, 2023. | DOI: 10.1097/MD.0000000000032734