Probiotic and prebiotic interventions for non-alcoholic fatty liver disease: a systematic review and network meta-analysis

2021 ◽  
pp. 1-14
Author(s):  
H. Jin ◽  
X. Xu ◽  
B. Pang ◽  
R. Yang ◽  
H. Sun ◽  
...  

Many studies have associated altered intestinal bacterial communities and non-alcoholic fatty liver disease, but the putative effects are inconclusive. The purpose of this network meta-analysis (NMA) was to evaluate the effects of probiotics, prebiotics, and synbiotics on non-alcoholic fatty liver disease through randomised intervention trials. Literature searches were performed until March 2020. For each outcome, a random NMA was performed, the surface under the cumulative ranking curve (SUCRA) was determined. A total of 22 randomised trials comparing prebiotic, probiotic, and synbiotic treatments included 1301 participants. Considering all seven results (aspartate aminotransferase, alanine aminotransferase, body mass index, weight, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol) together, the highest SUCRA values are probiotics (94%), synbiotics (61%) and prebiotics (56%), respectively. NMA results provide evidence that probiotics, prebiotics, and synbiotics can alleviate non-alcoholic fatty liver disease. However, due to the lack of high-quality randomised trials, this research also has some limitations.

2020 ◽  
Author(s):  
Aakash Shahi ◽  
Narayan Gautam ◽  
Sanju Rawal ◽  
Uday Sharma ◽  
Archana Jayan

Abstract Background: Fatty liver disease is a common and major chronic liver disease. It has been implicated that patients have disorders of lipid metabolism and involved in the pathogenesis of fatty liver. Lipid profile plays a very important role in diagnosis of liver diseases hence it was designed to observe relationship between lipid profile and fatty liver disease (FLD) based on ultrasonography (USG).Method and methodology: This Cross-sectional and analytical study was undertaken in the Department of Internal Medicine with collaboration of Department of Radiology and Department of Biochemistry, Universal College of Medical Sciences-Teaching Hospital (UCMS-TH), Bhairahawa, Nepal from March 2019 to February 2020 in total 100 patients diagnosed with FLD by USG.Result: In 100 cases, the male to female ratio was 1.8:1. 56% of the total cases presented with alcoholic fatty liver disease (AFLD) while remaining 44% with non alcoholic fatty liver disease (NAFLD). The spectrum of lipid abnormality was observed with increased total cholesterol (TC), Low Density Lipoprotein (LDL), increased triglycerides (TG) and Very Low Density Lipoprotein (VLDL) in AFLD cases as compared to NAFLD cases. However, it has been observed that TG/HDL and Non-HDL/HDL were higher in NAFLD as compared to AFLD. There was statistical significant difference in HDL (p-value: 0.019) between alcoholic fatty liver disease grade 1 (AFLG1) and non-alcoholic fatty liver disease grade 1 (NAFLG1). Moreover, it was observed statistical significant difference in HDL between AFLG2 and NAFLG2 (p-value: 0.012).Conclusion:Elevated level of TG and decreased HDL has been implicated in the precipitation of the occlusive vascular disease. These parameters in conjunction with Non-HDL/HDL and TG/HDL can be useful in early screening and monitoring of dyslipidemia in the fatty liver patients to prevent cardiovascular diseases.


2020 ◽  
pp. 20-20
Author(s):  
V.E. Gavrylenko

Objective. To evaluate the effectiveness of comprehensive treatment of patients with postoperative hypothyroidism (PH) and non-alcoholic fatty liver disease (NAFLD). Materials and methods. 40 patients (20 men and 20 women) aged 42±6 years with PH and NAFLD were examined. Patients were divided into two groups: main (n=20) and control (n=20). Prior to the study and after 1 month, the level of total cholesterol (TH), triglycerides (TG), low-density lipoprotein (LDL), alanine aminotransferase (ALT), aspartate aminotransferase (AST) was determined. Patients in both groups were prescribed levothyroxine sodium (125-175 μg a day). Additionally, the 1st group of patients received arginine hydrochloride 42 mg/ml according to the scheme 200 ml a day per 15 days, the next 15 days L-arginine aspartate 200 mg/ml 5 ml a day. And the control group received only levothyroxine sodium. Results. The level of TH in 1st group decreased from 7.1±0.8 to 6.7±0.4 mmol/l, and in 2nd – from 7.2±0.7 to 6.97±0.35 mmol/l. In the 1st group TG decreased from 3.9±0.4 to 3.5±0.3 mmol/l, and in the 2nd – from 3.8±0.5 to 3.7±0.1 mmol/l. LDL in 1st group decreased from 5.9±1.4 to 5.5±1.2 mmol/l, in the 2nd – from 5.8±1.3 to 5.7±1.4 mmol/l. The level of ALT in 1st group decreased from 47.5±1.82 to 40.1±1.73 IU/l, the level of AST – from 41.3±1.52 to 39.8±1.33 IU/l, in no changes in AST and ALT levels were observed in the control group. Conclusions. Comprehensive treatment of patients with PH and NAFLD contributed to the improvement of liver transaminases (reduction of AST, ALT), as well as the normalization of the lipid profile (reduction of TC, TG and LDL).


2019 ◽  
Vol 92 (1) ◽  
pp. 1-5
Author(s):  
Kaptan Singh ◽  
Divya Dahiya ◽  
Lileswar Kaman ◽  
Ashim Das

Background Gallstone disease (GSD) and non alcoholic fatty liver disease (NAFLD) has high prevalence in the general population and they share the common risk factors for their occurrence. Limited literature with inconsistent results is available suggesting the potential association between these life style induced diseases. Liver biopsy is the gold standard for diagnosing NAFLD. Aim of this study was (1) to identify the prevalence of asymptomatic NAFLD or NASH in liver biopsy specimen; (2) to identify association of hypercholesterolemia with NAFLD in patients undergoing laparoscopic cholecystectomy (LC). Methods This is a prospective observational study conducted on patients who underwent LC for symptomatic gallstones in the Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh from 1st July 2013 to 31st December 2014. All included patients had ultrasonography (USG); serum triglycerides (TG), cholesterol, low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol. A wedge liver biopsy was obtained from free edge of right liver lobe during LC and all biopsy specimens were analyzed by single pathologist. Results Dyslipidemia was present in 49.50% of 101 included patients. There was no association between NAFLD and serum cholesterol, TG or LDL-C (p 0.428, 0.848, 0.371 respectively). NAFLD was confirmed on liver biopsy in 21.8%; but none had fibrosis and cirrhosis on biopsy. There was no complication observed following liver biopsy. Conclusions Liver biopsy during LC gives an opportunity to diagnose the disease at an early and reversible stage. It is feasible, safe and cost effective.


Author(s):  
Yingzhe Xiong ◽  
Qingwen Peng ◽  
Chunmei Cao ◽  
Zujie Xu ◽  
Bing Zhang

Exercise could alleviate non-alcoholic fatty liver disease (NAFLD), but it was not clear which exercise methods could effectively treat NAFLD. The purpose of this systematic review and meta-analysis was to evaluate the effects of different exercise patterns on eight indicators in patients with NAFLD. We searched PubMed, Scopus, Web of Science, China National Knowledge Infrastructure, and the Wanfang Data from its inception to 30 June 2020. This review includes all randomized controlled trials (RCT) that assessed and compared the effects of different exercise on eight indicator parameters in patients with NAFLD. The results indicate that aerobic exercises could significantly improve the eight indicators in patients with NAFLD including triglycerides (TG, weighted mean difference (WMD) = −0.53, 95%CI: −0.68~−0.39, Z = 7.37, p < 0.01), total cholesterol (TC, WMD = −0.39, 95%CI: −0.55~−0.23, Z = 4.76, p < 0.01), low density lipoprotein (LDL, WMD = −0.47, 95%CI: −0.68~−0.26, Z = 4.33, p < 0.01), high density lipoprotein (HDL, WMD = 0.12, 95%CI: 0.05~0.18, Z = 3.56, p < 0.01), alanine aminotransferase (ALT, WMD = −6.14, 95%CI: −10.99~−1.29, Z = 2.48, p < 0.05), aspartate aminotransferase (AST, WMD = −5.73, 95%CI: −9.08~−2.38, Z = 3.36, p < 0.01), and body mass index (BMI, WMD = −0.85, 95%CI: −1.19~−0.51, Z = 4.92, p < 0.01). Resistance exercises could significantly reduce the levels of TG (WMD = −0.56, 95%CI: −0.85~−0.28, Z = 3.86, p < 0.01) and AST (WMD = −2.58, 95%CI: −4.79~−0.36, Z = 2.28, p < 0.05) in the patients. High-intensity interval training could significantly improve the level of ALT (WMD = −6.20, 95%CI: −9.34~−3.06, Z = 3.87, p < 0.01) in patients with NAFLD. These three exercise methods had different effects on the eight indexes of NAFLD in our present meta-analysis, providing some reference for the establishment of exercise prescription for patients with NAFLD.


2010 ◽  
Vol 1 (1) ◽  
pp. 38-45
Author(s):  
L. B Lazebnik ◽  
L. A Zvenigorodskaya ◽  
N. G Samsonova ◽  
E. A Cherkasova ◽  
N. V Melnikova

Dyslipidemia is currently accepted to be one of the major risk factor for cardiovascular diseases and atherosclerosis. There is no question that the liver plays an important role in the development of atherogenic dyslipidemia and it is simultaneously a target organ, which results in the development of non-alcoholic fatty liver disease (NAFLD). The latter limits the feasibilities of adequate hypolipidemic therapy, thus increasing the cardiovascular risks. There is a need to use hepatoprotectors when atherogenic dyslipidemia in a patient with documented NAFLD is treated with statins and fibrates. The choice of hepatoprotectors depends on the stage of NAFLD. It is expedient to take statins in combination with ursodeoxycholic acid preparations in NAFLD at the stage of steatosis. A combination of statins and a cholesterol absorption inhibitor is more effective in achieving low-density lipoprotein cholesterol goals in patients with hypercholesterolemia. Intestinal microflora-normalizing agents (enteric antiseptics, pre- and probiotics) should be included into a complex of hypolipidemic therapy in patients with NAFLD. Key words: atherogenic dyslipidemia, non-alcoholic fatty liver disease, hypolipidemic therapy.


2018 ◽  
Vol 38 (6) ◽  
Author(s):  
Meng Zhang ◽  
Yuan Yuan ◽  
Qing Wang ◽  
Xiaobo Li ◽  
Jiuzhang Men ◽  
...  

An effective treatment for non-alcoholic fatty liver disease (NAFLD) is urgently needed. In the present study, we investigated whether the Chinese medicine Chai Hu Li Zhong Tang (CHLZT) could protect against the development of NAFLD. Rats in an animal model of NAFLD were treated with CHLZT, and their serum levels of cholesterol (TC), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were detected with an automatic biochemical analyzer. A cellular model of NAFLD was also established by culturing HepG2 cells in a medium that contained a long chain fat emulsion. Those cells were treated with CHLZT that contained serum from rats. After treatment, the levels of adenylate-activated protein kinase (AMPK) α (AMPKα), p-AMPKα, acetyl coenzyme A carboxylase (ACC) α (ACCα), pACCα, PPARγ, and SREBP-2 were detected. The AMPK agonist, acadesine (AICAR), was used as a positive control compound. Our results showed that CHLZT or AICAR significantly decreased the serum levels of TG, TC, LDL-C, AST, ALT, and insulin in NAFLD rats, and significantly increased their serum HDL-C levels. Treatments with CHLZT or AICAR significantly decreased the numbers of lipid droplets in NAFLD liver tissues and HepG2 cells. CHLZT and AICAR increased the levels of p-AMPKα and PPARγ in the NAFLD liver tissues and HepG2 cells, but decreased the levels of ACC-α, p-ACC-α, SREBP-2, and 3-hydroxyl-3-methylglutaryl-coenzyme A reductase (HMGR). CHLZT protects against NAFLD by activating AMPKα, and also by inhibiting ACC activity, down-regulating SREBP2 and HMGR, and up-regulating PPAR-γ. Our results suggest that CHLZT might be useful for treating NAFLD in the clinic.


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