title: Beneficial Effect of Synbiotic Supplementation on Hepatic Steatosis and Anthropometric Parameters, But Not on Gut Permeability in a Population with Nonalcoholic Steatohepatitis.
abstract: Nonalcoholic fatty liver disease is the most prevalent chronic liver disease in Western countries; it can progress to nonalcoholic steatohepatitis (NASH), cirrhosis and hepatocarcinoma. The importance of gut-liver-adipose tissue axis has become evident and treatments targeting gut microbiota may improve inflammatory and metabolic parameters in NASH patients. In a randomized, controlled clinical trial, involving 50 biopsy-proven NASH patients, we investigated the effects of synbiotic supplementation on metabolic parameters, hepatic steatosis, intestinal permeability, small intestinal bacterial overgrowth (SIBO) and lipopolysaccharide (LPS) serum levels. Patients were separated into two groups receiving Lactobacillus reuteri with guar gum and inulin for three months and healthy balanced nutritional counseling versus nutritional counseling alone. Before and after the intervention we assessed steatosis by magnetic resonance imaging, intestinal permeability by lactulose/mannitol urinary excretion and SIBO by glucose breath testing. NASH patients presented high gut permeability, but low prevalence of SIBO. After the intervention, only the synbiotic group presented a reduction in steatosis, lost weight, diminished BMI and waist circumference measurement. Synbiotic did not improve intestinal permeability or LPS levels. We concluded that synbiotic supplementation associated with nutritional counseling seems superior to nutritional counseling alone for NASH treatment as it attenuates steatosis and may help to achieve weight loss.
authors.affiliation: Departamento de Cl&#237;nicaM&#233;dica, Faculdade de Medicina, Hospital das Cl&#237;nicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil. contato@silviaferolla.com.br.
authors.forename: Silvia M
authors.initials: SM
authors.lastname: Ferolla
authors.affiliation: Departamento de Cl&#237;nicaM&#233;dica, Faculdade de Medicina, Hospital das Cl&#237;nicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil. clacouto@hotmail.com.
authors.forename: Cláudia A
authors.initials: CA
authors.lastname: Couto
authors.affiliation: Departamento de Anatomia e Imagem, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil. lucianacosta@me.com.
authors.forename: Luciana
authors.initials: L
authors.lastname: Costa-Silva
authors.affiliation: Departamento de Cl&#237;nicaM&#233;dica, Faculdade de Medicina, Hospital das Cl&#237;nicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil. geyzaarmiliato@hotmail.com.
authors.forename: Geyza N A
authors.initials: GN
authors.lastname: Armiliato
authors.affiliation: Departamento de Cl&#237;nicaM&#233;dica, Faculdade de Medicina, Hospital das Cl&#237;nicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil. cristiano_asp@hotmail.com.
authors.forename: Cristiano A S
authors.initials: CA
authors.lastname: Pereira
authors.affiliation: Departamento de Microbiologia, Instituto de Ci&#234;ncias Biol&#243;gicas, Universidade Federal de Minas Gerais, Belo Horizonte31270-901, Brazil. flaviano@icb.ufmg.br.
authors.forename: Flaviano S
authors.initials: FS
authors.lastname: Martins
authors.affiliation: Departamento de Cl&#237;nicaM&#233;dica, Faculdade de Medicina, Hospital das Cl&#237;nicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil. lferrari@medicina.ufmg.br.
authors.forename: Maria de Lourdes A
authors.initials: Mde L
authors.lastname: Ferrari
authors.affiliation: Departamento de Cl&#237;nicaM&#233;dica, Faculdade de Medicina, Hospital das Cl&#237;nicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil. egarciavilela985@gmail.com.
authors.forename: Eduardo G
authors.initials: EG
authors.lastname: Vilela
authors.affiliation: Departamento de Cl&#237;nicaM&#233;dica, Faculdade de Medicina, Hospital das Cl&#237;nicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil. henrique.gamatorres@gmail.com.
authors.forename: Henrique O G
authors.initials: HO
authors.lastname: Torres
authors.affiliation: Departamento de Cl&#237;nicaM&#233;dica, Faculdade de Medicina, Hospital das Cl&#237;nicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil. aloisio@medicina.ufmg.br.
authors.forename: Aloísio S
authors.initials: AS
authors.lastname: Cunha
authors.affiliation: Departamento de Cl&#237;nicaM&#233;dica, Faculdade de Medicina, Hospital das Cl&#237;nicas, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil. tferrari@medicina.ufmg.br.
authors.forename: Teresa C A
authors.initials: TC
authors.lastname: Ferrari
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D000069196:Gastrointestinal Microbiome; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000382:microbiology*; D008070:Lipopolysaccharides / Q000097:blood; D008099:Liver / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000628:therapy*; D010539:Permeability; D058616:Synbiotics / Q000008:administration & dosage*; D055105:Waist Circumference
chemical_list: D008070:Lipopolysaccharides
keywords: gut microbiota; hepatic steatosis; intestinal permeability; lipopolysaccharide; nonalcoholic fatty liver disease; nonalcoholic steatohepatitis; obesity; probiotic; synbiotic; weight loss