Effects of combined prebiotic fiber supplementation and weight loss counseling in adults with metabolic dysfunction-associated steatotic liver disease: a randomized controlled trial.

IF 4.3 2区 医学 Q2 NUTRITION & DIETETICS European Journal of Nutrition Pub Date : 2025-04-02 DOI:10.1007/s00394-025-03660-7
Shyamchand Mayengbam, Maitreyi Raman, Jill A Parnell, Bertus Eksteen, Jennifer E Lambert, Lindsay K Eller, Alissa C Nicolucci, Michelle L Aktary, Raylene A Reimer
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Abstract

Purpose: Our aim was to examine the effects of combined prebiotic fiber supplementation and weight loss counseling on liver fat, body composition, subjective appetite, serum metabolomics, and intestinal microbiota in adults with MASLD.

Methods: In a double blind, placebo-controlled trial, adult participants aged 18-70 years old with MASLD were randomized to receive prebiotic (oligofructose-enriched inulin, 16 g/day; n = 22) or isocaloric placebo (maltodextrin; n = 20) for 24 weeks alongside weight loss counseling from a registered dietitian. Primary outcomes were change in intrahepatic fat % (IHF%) and hepatic injury from baseline to 24 weeks. Secondary outcomes included body composition, subjective appetite, serum lipids and cytokines, fecal microbiota, and serum metabolomics.

Results: At baseline, participants had IHF of 14.4 ± 8.4%. The change in IHF from baseline to 24 weeks did not differ between prebiotic and placebo. Prebiotic participants had a greater decrease (p = 0.029) in percent trunk fat compared to placebo. Compared to placebo, prebiotic significantly decreased desire to eat and hunger ratings over the course of the intervention. Fecal microbiota analysis showed a significant increase in Bifidobacterium abundance with prebiotic. A pathway analysis based on untargeted serum metabolomics revealed a downregulation of taurine and hypotaurine metabolism in the placebo group which was conserved in the prebiotic group.

Conclusion: Adding prebiotic fiber supplementation to weight loss counseling for adults with MASLD enhanced reductions in trunk fat and had a beneficial effect on subjective appetite compared to placebo. Improvements in fecal microbial profile and taurine metabolism revealed specific beneficial effects of prebiotics in the management of MASLD.

Clinical trial registration: Clinicaltrials.gov/study/NCT02568605.

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结合益生元纤维补充和减肥咨询对成人代谢功能障碍相关脂肪变性肝病的影响:一项随机对照试验
目的:我们的目的是研究复合益生元纤维补充和减肥咨询对MASLD成人肝脏脂肪、体成分、主观食欲、血清代谢组学和肠道微生物群的影响。方法:在一项双盲、安慰剂对照试验中,年龄在18-70岁的MASLD成年参与者随机接受益生元(富含低聚果糖的菊粉,16 g/天;N = 22)或等热量安慰剂(麦芽糖糊精;N = 20)持续24周,同时由注册营养师提供减肥咨询。主要结局是肝内脂肪% (IHF%)和肝损伤从基线到24周的变化。次要结局包括身体组成、主观食欲、血清脂质和细胞因子、粪便微生物群和血清代谢组学。结果:基线时,参与者的IHF为14.4±8.4%。从基线到24周的IHF变化在益生元和安慰剂之间没有差异。与安慰剂相比,益生元参与者的躯干脂肪百分比下降幅度更大(p = 0.029)。与安慰剂相比,在干预过程中,益生元显著降低了食欲和饥饿评级。粪便微生物群分析显示,益生元显著增加了双歧杆菌的丰度。基于非靶向血清代谢组学的途径分析显示,安慰剂组的牛磺酸和次牛磺酸代谢下调,而益生元组则保持不变。结论:与安慰剂相比,在MASLD成人减肥咨询中添加益生元纤维补充剂可以减少躯干脂肪,并对主观食欲产生有益影响。粪便微生物谱和牛磺酸代谢的改善揭示了益生元在治疗MASLD中的特定有益作用。临床试验注册:Clinicaltrials.gov/study/NCT02568605。
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来源期刊
CiteScore
10.20
自引率
2.00%
发文量
295
审稿时长
6 months
期刊介绍: The European Journal of Nutrition publishes original papers, reviews, and short communications in the nutritional sciences. The manuscripts submitted to the European Journal of Nutrition should have their major focus on the impact of nutrients and non-nutrients on immunology and inflammation, gene expression, metabolism, chronic diseases, or carcinogenesis, or a major focus on epidemiology, including intervention studies with healthy subjects and with patients, biofunctionality of food and food components, or the impact of diet on the environment.
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