• Efficacy of Synbiotic Supplementation in Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Clinical Trials
  • Hamed Mohammadi,1,* Amir Hadi,2 Sepide Talebi,3
    1. Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
    2. Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
    3. Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran


  • Introduction: Nonalcoholic fatty liver disease (NAFLD) is a silent and progressive disorder associated with excessive deposition of fatty acids, within hepatocytes in the absence of significant alcohol consumption. The prevalence of NAFLD is on the rise; recent estimated prevalence in developed and developing countries is approximately 20–30% and 10–20%, respectively. Thus, a comprehensive care and treatment plan for controlling the mentioned dysfunction is required. In this regard, lifestyle modification, in particular diet, is considered as the first line and the best treatment strategy in NAFLD. However, the difficulty in implementing and maintaining these lifestyle interventions in clinical practice in NAFLD patients is well documented. As a result, a convenient and effective adjunctive therapy with minimal side effect is needed. Although, several meta-analysis showed that probiotics significantly reduced the development of the NAFLD in adults and children, according to our search in databases, no systematic review or meta-analysis has performed regarding the separate role of synbiotic in this context. Therefore, present paper was conducted to collate and evaluate the overall effect of synbiotic supplementation on anthropometric indices, lipid profiles, glucose homeostasis parameters, inflammatory factors and liver enzymes in patients with NAFLD.
  • Methods: PubMed, Scopus, ISI Web of science and Google Scholar were searched up to December, 2017. All RCTs using synbiotic supplements to treat NAFLD included in this systematic review and meta-analysis. Mean Difference (MD) was pooled using a random effects model.
  • Results: Eleven eligible databases from seven RCTs were identified for the present meta-analysis. Our results showed that synbiotic supplementation can decrease body weight, fasting blood sugar, insulin, low density lipoprotein cholesterol, total cholesterol, triglyceride, high-sensitivity C-reactive protein, tumor necrosis factor alpha, alanine transaminase and aspartate transaminase levels among patients with NAFLD. In contrast, synbiotic did not have favorable effects on body mass index (BMI), waist circumference, homeostasis model assessment for insulin resistance (HOMA-IR), and high density lipoprotein cholesterol (HDL) levels compared with the placebo group.
  • Conclusion: The current study revealed that synbiotic supplementation has favorable effect on inflammatory factors, liver enzymes and some anthropometric indices, lipid profiles and glucose homeostasis parameters in patients with NAFLD.
  • Keywords: Synbiotic, inflammation, insulin, NAFLD