{"title":"合成抗生素对NAFLD患者的影响:一项系统回顾和荟萃分析。","authors":"Jiacheng Cai, Jia Dong, Dahua Chen, Hua Ye","doi":"10.1177/17562848231174299","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Nonalcoholic fatty liver disease (NAFLD) is the highest incidence of chronic liver disease worldwide, seriously endangering human health, and its pathogenesis is still unclear. In the recent years, increasing evidence has shown that intestinal flora plays an important role in the occurrence and development of NAFLD. Synbiotics can alter gut microbiota and may be a treatment option for NAFLD in the future.</p><p><strong>Objectives: </strong>To systematically investigate the therapeutic effect of synbiotic supplementation on NAFLD patients.</p><p><strong>Design: </strong>A systematic review and meta-analysis were conducted.</p><p><strong>Data sources and methods: </strong>We conducted a search on four databases (PubMed, Embase, Cochrane Library, and Web of Science) to identify relevant studies. Eligible studies were then screened, and data from the included studies were extracted, combined, and analyzed.</p><p><strong>Result: </strong>This study analyzed 10 randomized controlled trials involving 634 patients with NAFLD. The results showed that synbiotic supplementation could significantly reduce the level of alanine aminotransferase (mean difference (MD) = -8.80; (95% CI [-13.06, -4.53]), <i>p</i> < 0.0001), aspartate aminotransferase (MD = -9.48; 95% CI [-12.54, -6.43], <i>p</i> < 0.0001), and γ-glutamyl transferase (MD = -12.55; 95% CI [-19.40, -5.69], <i>p</i> = 0.0003) in NAFLD patients. In the field of metabolism, synbiotic supplementation could significantly reduce the level of total cholesterol (MD = -11.93; 95% CI [-20.43, -3.42], <i>p</i> = 0.006) and low-density lipoprotein cholesterol (MD = -16.2; 95% CI [-19.79, -12.60], <i>p</i> < 0.0001) and increase the level of high-density lipoprotein cholesterol (MD = 1.56; 95% CI [0.43, 2.68], <i>p</i> = 0.007) in NAFLD patients. In addition, synbiotic supplementation could significantly reduce liver stiffness measurement indicator (MD = -1.09; 95% CI [-1.87, -0.30], <i>p</i> = 0.006) and controlled attenuation parameter indicator (MD = -37.04; 95% CI [-56.78, -17.30], <i>p</i> = 0.0002) in NAFLD patients.</p><p><strong>Conclusion: </strong>Based on the current evidence, synbiotic supplementation can improve liver function, adjust lipid metabolism, and reduce the degree of liver fibrosis in patients with NAFLD, but these effects need to be confirmed by further studies.</p>","PeriodicalId":23022,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"16 ","pages":"17562848231174299"},"PeriodicalIF":4.2000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/5b/10.1177_17562848231174299.PMC10302525.pdf","citationCount":"1","resultStr":"{\"title\":\"The effect of synbiotics in patients with NAFLD: a systematic review and meta-analysis.\",\"authors\":\"Jiacheng Cai, Jia Dong, Dahua Chen, Hua Ye\",\"doi\":\"10.1177/17562848231174299\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Nonalcoholic fatty liver disease (NAFLD) is the highest incidence of chronic liver disease worldwide, seriously endangering human health, and its pathogenesis is still unclear. In the recent years, increasing evidence has shown that intestinal flora plays an important role in the occurrence and development of NAFLD. Synbiotics can alter gut microbiota and may be a treatment option for NAFLD in the future.</p><p><strong>Objectives: </strong>To systematically investigate the therapeutic effect of synbiotic supplementation on NAFLD patients.</p><p><strong>Design: </strong>A systematic review and meta-analysis were conducted.</p><p><strong>Data sources and methods: </strong>We conducted a search on four databases (PubMed, Embase, Cochrane Library, and Web of Science) to identify relevant studies. Eligible studies were then screened, and data from the included studies were extracted, combined, and analyzed.</p><p><strong>Result: </strong>This study analyzed 10 randomized controlled trials involving 634 patients with NAFLD. The results showed that synbiotic supplementation could significantly reduce the level of alanine aminotransferase (mean difference (MD) = -8.80; (95% CI [-13.06, -4.53]), <i>p</i> < 0.0001), aspartate aminotransferase (MD = -9.48; 95% CI [-12.54, -6.43], <i>p</i> < 0.0001), and γ-glutamyl transferase (MD = -12.55; 95% CI [-19.40, -5.69], <i>p</i> = 0.0003) in NAFLD patients. In the field of metabolism, synbiotic supplementation could significantly reduce the level of total cholesterol (MD = -11.93; 95% CI [-20.43, -3.42], <i>p</i> = 0.006) and low-density lipoprotein cholesterol (MD = -16.2; 95% CI [-19.79, -12.60], <i>p</i> < 0.0001) and increase the level of high-density lipoprotein cholesterol (MD = 1.56; 95% CI [0.43, 2.68], <i>p</i> = 0.007) in NAFLD patients. 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引用次数: 1
摘要
背景:非酒精性脂肪性肝病(NAFLD)是世界范围内发病率最高的慢性肝病，严重危害人类健康，其发病机制尚不清楚。近年来，越来越多的证据表明，肠道菌群在NAFLD的发生发展中起着重要作用。合生剂可以改变肠道微生物群，将来可能成为NAFLD的一种治疗选择。目的:系统观察合成制剂对NAFLD患者的治疗效果。设计:进行系统回顾和荟萃分析。数据来源和方法:我们对四个数据库(PubMed、Embase、Cochrane Library和Web of Science)进行了检索，以确定相关研究。然后筛选符合条件的研究，并从纳入的研究中提取、合并和分析数据。结果:本研究分析了10项随机对照试验，涉及634例NAFLD患者。结果表明:饲粮中添加合成菌可显著降低蛋鸡丙氨酸转氨酶水平(平均差值(MD) = -8.80;(95% CI[-13.06, -4.53]),非酒精性脂肪肝患者p p p = 0.0003)。在代谢方面，添加合成菌可显著降低总胆固醇水平(MD = -11.93;95% CI [-20.43， -3.42]， p = 0.006)和低密度脂蛋白胆固醇(MD = -16.2;95% CI [-19.79， -12.60]， p p = 0.007)。此外，添加合成菌可显著降低肝脏硬度测量指标(MD = -1.09;95% CI [-1.87， -0.30]， p = 0.006)和可控衰减参数指标(MD = -37.04;95% CI [-56.78， -17.30]， p = 0.0002)。结论:根据目前的证据，补充合成菌可改善NAFLD患者肝功能，调节脂质代谢，降低肝纤维化程度，但这些作用有待进一步研究证实。
The effect of synbiotics in patients with NAFLD: a systematic review and meta-analysis.
Background: Nonalcoholic fatty liver disease (NAFLD) is the highest incidence of chronic liver disease worldwide, seriously endangering human health, and its pathogenesis is still unclear. In the recent years, increasing evidence has shown that intestinal flora plays an important role in the occurrence and development of NAFLD. Synbiotics can alter gut microbiota and may be a treatment option for NAFLD in the future.
Objectives: To systematically investigate the therapeutic effect of synbiotic supplementation on NAFLD patients.
Design: A systematic review and meta-analysis were conducted.
Data sources and methods: We conducted a search on four databases (PubMed, Embase, Cochrane Library, and Web of Science) to identify relevant studies. Eligible studies were then screened, and data from the included studies were extracted, combined, and analyzed.
Result: This study analyzed 10 randomized controlled trials involving 634 patients with NAFLD. The results showed that synbiotic supplementation could significantly reduce the level of alanine aminotransferase (mean difference (MD) = -8.80; (95% CI [-13.06, -4.53]), p < 0.0001), aspartate aminotransferase (MD = -9.48; 95% CI [-12.54, -6.43], p < 0.0001), and γ-glutamyl transferase (MD = -12.55; 95% CI [-19.40, -5.69], p = 0.0003) in NAFLD patients. In the field of metabolism, synbiotic supplementation could significantly reduce the level of total cholesterol (MD = -11.93; 95% CI [-20.43, -3.42], p = 0.006) and low-density lipoprotein cholesterol (MD = -16.2; 95% CI [-19.79, -12.60], p < 0.0001) and increase the level of high-density lipoprotein cholesterol (MD = 1.56; 95% CI [0.43, 2.68], p = 0.007) in NAFLD patients. In addition, synbiotic supplementation could significantly reduce liver stiffness measurement indicator (MD = -1.09; 95% CI [-1.87, -0.30], p = 0.006) and controlled attenuation parameter indicator (MD = -37.04; 95% CI [-56.78, -17.30], p = 0.0002) in NAFLD patients.
Conclusion: Based on the current evidence, synbiotic supplementation can improve liver function, adjust lipid metabolism, and reduce the degree of liver fibrosis in patients with NAFLD, but these effects need to be confirmed by further studies.
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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