title: Effects of probiotics on nonalcoholic fatty liver disease: a meta-analysis.
abstract: OBJECTIVE
  To investigate the relationship between the gut-liver axis and nonalcoholic fatty liver disease (NAFLD), we performed a meta-analysis to evaluate the effects of probiotic therapy in NAFLD.
  
  
  METHODS
  We searched PubMed, Medline, Embase, Web of Science, the Cochrane Library and Chinese Biomedicine Database for all relevant randomized controlled trials on probiotics in patients with NAFLD/nonalcoholic steatohepatitis (NASH). A statistical analysis was performed using RevMan 5.0 software.
  
  
  RESULTS
  Four randomized trials involving 134 NAFLD/NASH patients were included. The results showed that probiotic therapy signiﬁcantly decreased alanine aminotransferase (ALT), aspartate transaminase (AST), total-cholesterol (T-chol), high density lipoprotein (HDL), tumor necrosis factor (TNF)-α and homeostasis model assessment of insulin resistance (HOMA-IR) [ALT: weighted mean difference (WMD) -23.71, 95%CI: -33.46--13.95, P < 0.00001; AST: WMD -19.77, 95%CI: -32.55--7.00, P = 0.002; T-chol: WMD -0.28, 95%CI: -0.55--0.01, P = 0.04; HDL: WMD -0.09, 95%CI: -0.16-0.01, P = 0.03; TNF-α: WMD -0.32, 95%CI: -0.48--0.17, P < 0.0001; HOMA-IR: WMD -0.46, 95%CI: -0.73--0.19, P = 0.0008]. However, the use of probiotics was not associated with changes in body mass index (BMI), glucose (GLU) and low density lipoprotein (LDL) (BMI: WMD 0.05, 95%CI: -0.18-0.29, P = 0.64; GLU: WMD 0.05, 95%CI: -0.25-0.35, P = 0.76; LDL: WMD -0.38, 95%CI: -0.78-0.02, P = 0.06).
  
  
  CONCLUSIONS
  Probiotic therapies can reduce liver aminotransferases, total-cholesterol, TNF-α and improve insulin resistance in NAFLD patients. Modulation of the gut microbiota represents a new treatment for NAFLD.
authors.affiliation: Yan-Yan Ma, Lin Li, Chao-Hui Yu, Zhe Shen, Li-Hua Chen, You-Ming Li, Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Yan-Yan
authors.initials: YY
authors.lastname: Ma
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.forename: Chao-Hui
authors.initials: CH
authors.lastname: Yu
authors.forename: Zhe
authors.initials: Z
authors.lastname: Shen
authors.forename: Li-Hua
authors.initials: LH
authors.lastname: Chen
authors.forename: You-Ming
authors.initials: YM
authors.lastname: Li
mesh_terms: D016009:Chi-Square Distribution; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D006801:Humans; D007333:Insulin Resistance; D007422:Intestines / Q000382:microbiology; D050356:Lipid Metabolism; D008099:Liver / Q000378:metabolism; D065626:Non-alcoholic Fatty Liver Disease; D016017:Odds Ratio; D019936:Probiotics / Q000627:therapeutic use*; D016896:Treatment Outcome
keywords: Insulin resistance; Liver function; Meta-analysis; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Probiotics