The effect of probiotic consumption on lipid profile, glycemic index, inflammatory markers, and liver function in NAFLD patients: A systematic review and meta-analysis of randomized controlled trials

Non-alcoholic fatty liver disease (NAFLD11Non-alcoholic fatty liver disease) is the most frequent chronic liver disorder worldwide. Currently, no pharmacological treatment has been approved for NAFLD. Probiotics have been suggested as a potential therapy for NAFLD. The aim of this systematic review and meta-analysis was to assess the impact of probiotic intake on liver tests, lipids, glycemic parameters and inflammatory markers in NAFLD patients. We searched electronic databases using related terms. Meta-analysis was performed using random-effects models. Clinical outcomes were presented as standard mean difference (SMD22standard mean difference) with a 95 % confidence interval (CI33confidence interval). Publication bias and heterogeneity were evaluated in eligible studies. Fifteen randomized clinical trials comprising 899 participants were included in our meta-analysis. Probiotic supplementation improved alanine transaminase [SMD -0.796; 95 % CI (−1.419, −0.172); p = 0.012], Homeostatic Model Assessment for Insulin Resistance (HOMA-IR44Homeostasis model assessment-estimated insulin resistance) [SMD -0.596; 95 % CI (−1.071, −0.121); p = 0.01] and insulin levels [SMD -1.10; 95 % CI (−2.121, −0.087); p = 0.03]. No significant effects were observed on fasting glucose, hemoglobin A1c, aspartate transaminase, lipid profile, interleukin-6 and tumor necrosis factor-α. Probiotic intake may improve insulin sensitivity and alanine transaminase in NAFLD patients. •Non-alcoholic fatty liver disease (NAFLD) is the most frequent chronic liver disorder worldwide.•Currently, no pharmacological treatment has been approved for NAFLD.•Probiotics have been suggested as a potential therapy for NAFLD.•Probiotic supplementation improved alanine transaminase, Homeostatic Model Assessment for Insulin Resistance and insulin levels.•Further research is needed to establish the clinical use of probiotics in NAFLD