Optimal probiotic combinations for treating nonalcoholic fatty liver disease: A systematic review and network meta-analysis

source extracted confidence: high 2026-04-09
#probiotics #humans #non-alcoholic-fatty-liver-disease #lactobacillus #bifidobacterium

Optimal probiotic combinations for treating nonalcoholic fatty liver disease: A systematic review and network meta-analysis

Yang et al., 2024 | Clin Nutr | Systematic Review

Citation

Yang Yafang, Yang Ligang, ... Yang Chao. Optimal probiotic combinations for treating nonalcoholic fatty liver disease: A systematic review and network meta-analysis. Clin Nutr. 2024-Jun;43(6):1224-1239. doi:10.1016/j.clnu.2024.04.004

Abstract

BACKGROUND: Probiotic administration is a promising therapy for improving conditions in NAFLD patients. This network meta-analysis aimed to compare and estimate the relative effects of probiotic interventions and identify the optimal probiotic species for the treatment of NAFLD (Nonalcoholic fatty liver disease) patients. METHODS: The PubMed, Web of Science, Embase, and Cochrane databases were searched from inception to 29 January 2024 to identify RCTs that were published in English. The GRADE framework was used to assess the quality of evidence contributing to each network estimate. RESULTS: A total of 35 RCTs involving 2212 NAFLD patients were included in the analysis. For primary outcomes, Lactobacillus + Bifidobacterium + Streptococcus exhibited the highest probability of being the finest probiotic combination in terms of enhancing acceptability as well as reducing AST (SMD: -1.95 95% CI: -2.90, -0.99), ALT (SMD = -1.67, 95% CI: -2.48, -0.85), and GGT levels (SMD = -2.17, 95% CI: -3.27, -1.06). In terms of the secondary outcomes, Lactobacillus + Bifidobacterium + Streptococcus was also the best probiotic combination for reducing BMI (SMD = -0.45, 95% CI: -0.86, -0.04), LDL levels (SMD = -0.45, 95% CI: -0.87, -0.02), TC levels (SMD = -1.09, 95% CI: -1.89, -0.29), and TNF-α levels (SMD = -1.73, 95% CI: -2.72, -0.74). CONCLUSION: This network meta-analysis revealed that Lactobacillus + Bifidobacterium + Streptococcus may be the most effective probiotic combination for the treatment of liver enzymes, lipid profiles, and inflammation factors. These findings can be used to guide the development of a probiotics-based treatment guideline for NAFLD since there are few direct comparisons between different therapies.

Key Findings

A total of 35 RCTs involving 2212 NAFLD patients were included in the analysis. For primary outcomes, Lactobacillus + Bifidobacterium + Streptococcus exhibited the highest probability of being the finest probiotic combination in terms of enhancing acceptability as well as reducing AST (SMD: -1.95 95% CI: -2.90, -0.99), ALT (SMD = -1.67, 95% CI: -2.48, -0.85), and GGT levels (SMD = -2.17, 95% CI: -3.27, -1.06). In terms of the secondary outcomes, Lactobacillus + Bifidobacterium + Streptococcus wa

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 35
Age Range See abstract
Condition inflammation

MeSH Terms

  • Probiotics
  • Humans
  • Non-alcoholic Fatty Liver Disease
  • Lactobacillus
  • Bifidobacterium
  • Streptococcus
  • Treatment Outcome

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Systematic Review, Journal Article, Network Meta-Analysis, Research Support, Non-U.S. Gov't
  • Vertical: probiotics

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09