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Probiotic and prebiotic interventions for non-alcoholic fatty liver disease: a systematic review and network meta-analysis

in Beneficial Microbes
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H. Jin A Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi’an, Shaanxi Province 710072, China P.R.

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X. Xu A Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi’an, Shaanxi Province 710072, China P.R.

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B. Pang A Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi’an, Shaanxi Province 710072, China P.R.

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R. Yang A Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi’an, Shaanxi Province 710072, China P.R.

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H. Sun A Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi’an, Shaanxi Province 710072, China P.R.
School of Hospitality Management, Guilin Tourism University, 26 Liangfeng Road, Yanshan District, Guilin City, Guangxi Province 541006, China P.R.

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C. Jiang A Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi’an, Shaanxi Province 710072, China P.R.

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D. Shao A Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi’an, Shaanxi Province 710072, China P.R.

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J. Shi A Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, 127 Youyi West Road, Xi’an, Shaanxi Province 710072, China P.R.

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Many studies have associated altered intestinal bacterial communities and non-alcoholic fatty liver disease, but the putative effects are inconclusive. The purpose of this network meta-analysis (NMA) was to evaluate the effects of probiotics, prebiotics, and synbiotics on non-alcoholic fatty liver disease through randomised intervention trials. Literature searches were performed until March 2020. For each outcome, a random NMA was performed, the surface under the cumulative ranking curve (SUCRA) was determined. A total of 22 randomised trials comparing prebiotic, probiotic, and synbiotic treatments included 1301 participants. Considering all seven results (aspartate aminotransferase, alanine aminotransferase, body mass index, weight, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol) together, the highest SUCRA values are probiotics (94%), synbiotics (61%) and prebiotics (56%), respectively. NMA results provide evidence that probiotics, prebiotics, and synbiotics can alleviate non-alcoholic fatty liver disease. However, due to the lack of high-quality randomised trials, this research also has some limitations.

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