The effects of gut microbiome manipulation on glycemic indices in patients with non-alcoholic fatty liver disease: a comprehensive umbrella review.

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Nutrition & Diabetes Pub Date : 2024-05-10 DOI:10.1038/s41387-024-00281-7

Azin Vakilpour, Ehsan Amini-Salehi, Arman Soltani Moghadam, Mohammad-Hossein Keivanlou, Negin Letafatkar, Arman Habibi, Mohammad Hashemi, Negar Eslami, Reza Zare, Naeim Norouzi, Hamed Delam, Farahnaz Joukar, Fariborz Mansour-Ghanaei, Soheil Hassanipour, Sandeep Samethadka Nayak

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Abstract

Background: Type 2 diabetes mellitus (T2DM) is a significant risk factor for non-alcoholic fatty liver disease (NAFLD). Increased fasting blood sugar (FBS), fasting insulin (FI), and insulin resistance (HOMA-IR) are observed in patients with NAFLD. Gut microbial modulation using prebiotics, probiotics, and synbiotics has shown promise in NAFLD treatment. This meta-umbrella study aimed to investigate the effects of gut microbial modulation on glycemic indices in patients with NAFLD and discuss potential mechanisms of action.

Methods: A systematic search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library until March 2023 for meta-analyses evaluating the effects of probiotics, prebiotics, and synbiotics on patients with NAFLD. Random-effect models, sensitivity analysis, and subgroup analysis were employed.

Results: Gut microbial therapy significantly decreased HOMA-IR (ES: -0.41; 95%CI: -0.52, -0.31; P < 0.001) and FI (ES: -0.59; 95%CI: -0.77, -0.41; P < 0.001). However, no significant effect was observed on FBS (ES: -0.17; 95%CI: -0.36, 0.02; P = 0.082). Subgroup analysis revealed prebiotics had the most potent effect on HOMA-IR, followed by probiotics and synbiotics. For FI, synbiotics had the most substantial effect, followed by prebiotics and probiotics.

Conclusion: Probiotics, prebiotics, and synbiotics administration significantly reduced FI and HOMA-IR, but no significant effect was observed on FBS.

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肠道微生物组操作对非酒精性脂肪肝患者血糖指数的影响：综述。

背景：2 型糖尿病（T2DM）是非酒精性脂肪肝（NAFLD）的重要风险因素。非酒精性脂肪肝患者的空腹血糖（FBS）、空腹胰岛素（FI）和胰岛素抵抗（HOMA-IR）都会增加。使用益生菌、益生菌和合成益生菌调节肠道微生物已显示出治疗非酒精性脂肪肝的前景。这项荟萃研究旨在调查肠道微生物调节对非酒精性脂肪肝患者血糖指数的影响，并讨论潜在的作用机制：截至 2023 年 3 月，我们在 PubMed、Web of Science、Scopus 和 Cochrane 图书馆进行了系统检索，以了解评估益生菌、益生元和合成益生菌对非酒精性脂肪肝患者影响的荟萃分析。研究采用了随机效应模型、敏感性分析和亚组分析：肠道微生物疗法明显降低了 HOMA-IR（ES：-0.41；95%CI：-0.52，-0.31；P 结论：益生菌、益生元和增效益生菌对非酒精性脂肪肝患者的疗效非常明显：服用益生菌、益生元和合生元能明显降低 FI 和 HOMA-IR，但对 FBS 没有明显影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutrition & Diabetes ENDOCRINOLOGY & METABOLISM-NUTRITION & DIETETICS

CiteScore

9.20

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Nutrition & Diabetes is a peer-reviewed, online, open access journal bringing to the fore outstanding research in the areas of nutrition and chronic disease, including diabetes, from the molecular to the population level.