The effect of synbiotics on liver enzymes, obesity indices, blood pressure, lipid profile, and inflammation in patients with non-alcoholic fatty liver: A systematic review and meta-analysis of randomized controlled trials.

ABSTRACT

BACKGROUND: Patients with non-alcoholic fatty liver disease (NAFLD) benefit from using synbiotics. However, findings from existing trials remain contentious. Therefore, this meta-analysis evaluated the effects of synbiotics on liver enzymes, blood pressure, inflammation, and lipid profiles in patients with NAFLD. METHODS: We searched PubMed, Embase, Cochrane, Scopus, and Web of Science for randomized controlled trials (RCTs) regarding synbiotics supplementation in patients with NAFLD. RESULTS: The meta-analysis revealed that synbiotics supplementation significantly improved liver enzymes (AST, WMD -9.12 IU/L; 95 % CI -13.19 to -5.05; ALT, WMD -8.53 IU/L; 95 % CI -15.07 to -1.99; GGT, WMD -10.42 IU/L; 95 % CI -15.19 to -5.65), lipid profile (TC, WMD -7.74 mg/dL; 95 % CI -12.56 to -2.92), obesity indices (body weight, WMD -1.95 kg; 95 % CI -3.69 to -0.22; WC, WMD -1.40 cm; 95 % CI -2.71 to -0.10), systolic blood pressure (SBP, WMD -6.00 mmHg; 95 % CI -11.52 to -0.49), and inflammatory markers (CRP, WMD -0.69 mg/L; 95 % CI -1.17 to -0.21; TNF-α, WMD -14.01 pg/mL; 95 % CI -21.81 to -6.20). CONCLUSION: Overall, supplementation with synbiotics positively improved liver enzymes, obesity indices, and inflammatory cytokines in patients with NAFLD.