Abstract

Background

Type 2 diabetes mellitus (T2DM) is a significant risk factor for non-alcoholic fatty liver disease (NAFLD). Increased fasting blood sugar (FBS), fasting insulin (FI), and insulin resistance (HOMA-IR) are observed in patients with NAFLD. Gut microbial modulation using prebiotics, probiotics, and synbiotics has shown promise in NAFLD treatment. This meta-umbrella study aimed to investigate the effects of gut microbial modulation on glycemic indices in patients with NAFLD and discuss potential mechanisms of action.

Methods

A systematic search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library until March 2023 for meta-analyses evaluating the effects of probiotics, prebiotics, and synbiotics on patients with NAFLD. Random-effect models, sensitivity analysis, and subgroup analysis were employed.

Results

Gut microbial therapy significantly decreased HOMA-IR (ES: −0.41; 95%CI: −0.52, −0.31; P < 0.001) and FI (ES: −0.59; 95%CI: −0.77, −0.41; P < 0.001). However, no significant effect was observed on FBS (ES: −0.17; 95%CI: −0.36, 0.02; P = 0.082). Subgroup analysis revealed prebiotics had the most potent effect on HOMA-IR, followed by probiotics and synbiotics. For FI, synbiotics had the most substantial effect, followed by prebiotics and probiotics.

Conclusion

Probiotics, prebiotics, and synbiotics administration significantly reduced FI and HOMA-IR, but no significant effect was observed on FBS.

Details

Title
The effects of gut microbiome manipulation on glycemic indices in patients with non-alcoholic fatty liver disease: a comprehensive umbrella review
Author
Vakilpour, Azin 1 ; Amini-Salehi, Ehsan 2 ; Soltani Moghadam, Arman 3 ; Keivanlou, Mohammad-Hossein 4   VIAFID ORCID Logo  ; Letafatkar, Negin 4 ; Habibi, Arman 4 ; Hashemi, Mohammad 5 ; Eslami, Negar 2 ; Zare, Reza 6 ; Norouzi, Naeim 2 ; Delam, Hamed 6 ; Joukar, Farahnaz 2 ; Mansour-Ghanaei, Fariborz 2 ; Hassanipour, Soheil 2 ; Samethadka Nayak, Sandeep 7 

1  Guilan University of Medical Sciences, Rasht, Iran (GRID:grid.411874.f) (ISNI:0000 0004 0571 1549) 
2  Guilan University of Medical Sciences, Gastrointestinal and Liver Diseases Research Center, Rasht, Iran (GRID:grid.411874.f) (ISNI:0000 0004 0571 1549) 
3  Tehran University of Medical Sciences, Tehran, Iran (GRID:grid.411705.6) (ISNI:0000 0001 0166 0922) 
4  Guilan University of Medical Sciences, Gastrointestinal and Liver Diseases Research Center, Rasht, Iran (GRID:grid.411874.f) (ISNI:0000 0004 0571 1549); Guilan University of Medical Sciences, Student Research Committee, School of Medicine, Rasht, Iran (GRID:grid.411874.f) (ISNI:0000 0004 0571 1549) 
5  Hormozgan University of Medical Sciences, Student Research Committee, Faculty of Medicine, Bandar Abbas, Iran (GRID:grid.412237.1) (ISNI:0000 0004 0385 452X) 
6  Larestan University of Medical Sciences, Student Research Committee, Larestan, Iran (GRID:grid.508728.0) (ISNI:0000 0004 0612 1516) 
7  Yale New Haven Health Bridgeport Hospital, Department of Internal Medicine, Bridgeport CT, USA (GRID:grid.414600.7) (ISNI:0000 0004 0379 8695) 
Pages
25
Publication year
2024
Publication date
2024
Publisher
Nature Publishing Group
e-ISSN
20444052
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41387-024-00281-7
ProQuest document ID
3053353634
Copyright
© The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.