益生菌在治疗非酒精性脂肪肝（NAFLD）中的作用：基于荟萃分析和亚组分析的新见解

IF 4.8 1区农林科学 Q1 FOOD SCIENCE & TECHNOLOGY

Food Bioscience Pub Date : 2024-11-14 DOI:10.1016/j.fbio.2024.105454

Rui Xiao , Yang Cao , Linlin Wang , Peijun Tian , Qixiao Zhai , Jianxin Zhao , Gang Wang , Yu Zhu

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引用次数: 0

摘要

尽管大量研究表明益生菌与非酒精性脂肪肝（NAFLD）之间存在联系，但其对临床结果的影响仍存在争议。本荟萃分析评估了益生菌对非酒精性脂肪肝患者肝酶、血糖控制、血脂和炎症的影响。在PubMed、Web of Science、Embase和Cochrane图书馆进行了截至2024年4月的全面检索，没有语言限制。采用随机效应模型得出综合结果，并对体重指数、研究地点和干预持续时间进行亚组分析。纳入了来自 15 个国家、1940 名参与者的 33 项研究，观察到 ALT（SMD：-0.87，95% CI：-1.22，-0.53）、AST（SMD：-1.10，95% CI：-1.48，-0.71）、空腹血糖（SMD：-0.30，95% CI：-0.49，-0.11）、空腹胰岛素（SMD：-0.64，95% CI：-1.20，-0.07）、HbA1c（SMD：-0.45，95% CI：-0.85，-0.06）、胰岛素抵抗（SMD：-0.35，95% CI：-0.56，-0.14）、总胆固醇（SMD：-0.39，95% CI：-0.66，-0.11）、甘油三酯（SMD：-0.27，95% CI：-0.43，-0.12）、低密度脂蛋白胆固醇（SMD：-0.31，95% CI：-0.52，-0.10）和 TNF-α（SMD：-0.99，95% CI：-1.67，-0.31）。亚组分析表明，多菌株或复合益生菌比单菌株益生菌更有效。对空腹胰岛素、总胆固醇和 TNF-α 的疗效受体重指数和地理区域的显著影响。我们的研究结果表明，益生菌能明显改善非酒精性脂肪肝患者的肝酶水平、血脂状况、血糖控制和炎症指标。多菌株益生菌或联合补充剂尤其能提高胰岛素敏感性，降低总胆固醇和TNF-α水平，尤其适用于55岁或以下、基线体重指数低于30 kg/m2的人群。

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The role of probiotics in the treatment of non-alcoholic fatty liver disease (NAFLD): New insights based on meta-analysis and subgroup analysis

Despite numerous studies suggesting a link between probiotics and non-alcoholic fatty liver disease (NAFLD), the effects on clinical outcomes remain contentious. This meta-analysis evaluates probiotic effects on liver enzymes, glycaemic control, lipids, and inflammation in NAFLD patients. Comprehensive searches up to April 2024 in PubMed, Web of Science, Embase, and Cochrane Library were conducted without language restrictions. A random-effects model derived aggregated outcomes, with subgroup analyses for BMI, study location, and intervention duration. Incorporating 33 studies with 1940 participants from 15 countries, significant reductions were observed in ALT (SMD: −0.87, 95% CI: −1.22, −0.53), AST (SMD: −1.10, 95% CI: −1.48, −0.71), fasting blood glucose (SMD: −0.30, 95% CI: −0.49, −0.11), fasting insulin (SMD: −0.64, 95% CI: −1.20, −0.07), HbA1c (SMD: −0.45, 95% CI: −0.85, −0.06), insulin resistance (SMD: −0.35, 95% CI: −0.56, −0.14), total cholesterol (SMD: −0.39, 95% CI: −0.66, −0.11), triglycerides (SMD: −0.27, 95% CI: −0.43, −0.12), low-density lipoprotein cholesterol (SMD: −0.31, 95% CI: −0.52, −0.10), and TNF-α (SMD: −0.99, 95% CI: −1.67, −0.31) compared to controls. Subgroup analyses showed multi-strain or combined probiotics were more effective than single-strain. Efficacy on fasting insulin, total cholesterol, and TNF-α was significantly influenced by BMI and geographic region. Our findings suggest probiotics significantly improve liver enzyme levels, blood lipid profiles, blood glucose control, and inflammatory markers in NAFLD patients. Multi-strain probiotics or combined supplements particularly enhance insulin sensitivity and reduce total cholesterol and TNF-α levels, especially in individuals aged 55 years or younger and those with a baseline BMI below 30 kg/m².

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来源期刊

Food Bioscience Biochemistry, Genetics and Molecular Biology-Biochemistry

CiteScore

6.40

自引率

5.80%

发文量

671

审稿时长

27 days

期刊介绍： Food Bioscience is a peer-reviewed journal that aims to provide a forum for recent developments in the field of bio-related food research. The journal focuses on both fundamental and applied research worldwide, with special attention to ethnic and cultural aspects of food bioresearch.