Effect of synbiotic supplementation on liver function, metabolic profile and gut microbiota in non-alcoholic fatty liver disease (NAFLD): A meta-analysis of randomized controlled trials

Abstract

This systematic review and meta-analysis examine the impact of synbiotics on non-alcoholic fatty liver disease (NAFLD) by evaluating changes in lipid, glucose, and inflammatory profiles. A search across PubMed/Medline, Cochrane Library, Scopus, Cambridge Core, and CINAHL yielded 302 articles, with 11 meeting the criteria for randomized controlled trials. The studies consistently reported that synbiotic treatment for NAFLD led to a reduction in liver enzymes ALT and AST, with significant effect sizes (SMD = -1.27, 95% CI: -2.07 to -0.46, P = .002; SMD = -0.67, 95% CI: -0.86 to -0.47, P = .00001). Additionally, synbiotics demonstrated a favorable impact on lipid profiles, lowering TC and LDL levels (SMD = -0.32, 95% CI: -0.56 to -0.07, P = .01; SMD = -0.05, 95% CI: -0.90 to -0.21, P = .002). The treatment also improved glucose profiles, as evidenced by reduced Glucose and HOMA-IR levels (SMD = -0.29, 95% CI: -0.53 to -0.04, P = .02; SMD = -2.45, 95% CI: -3.79 to -1.11, P = .0003), while pro-inflammatory cytokines, TNF-α, decreased significantly (SMD = -1.01, 95% CI: -1.32 to -0.71, P = .00001). In conclusion, synbiotic therapy emerges as a promising approach for enhancing liver function and metabolic profiles in NAFLD patients, as supported by the findings of this review.