益生菌对非酒精性脂肪性肝病改善作用的Meta分析

EFFECTS OF PROBIOTICS ON NON-ALCOHOLIC FATTY LIVER DISEASES:A META-ANALYSIS

目的通过Meta分析,了解益生菌干预对非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)改善效果。方法检索2007年1月至2021年3月发表在Embase,Pubmed,Cochrance Library,Web of Science,CBM,CNKI,万方和维普数据库中益生菌对非酒精性脂肪性肝病改善作用的随机对照试验。根据纳入排除标准,确定符合条件的研究。随机对照试验结果用随机效应模型进行汇总,异质性用统计学指标I^(2)进行评估。结果纳入9项随机对照试验包含NAFLD/NASH患者694例。使用益生菌干预后相比于对照组谷丙转氨酶降低了8.02 IU/L,谷草转氨酶降低了5.34IU/L,总胆固醇降低了0.57mmol/L,甘油三酯降低了0.72mmol/L,空腹血糖降低了0.21 mmol/L,胰岛素抵抗模型评估降低了0.37,胰岛素降低了3.06μU/ml,白介素-6降低0.25 pg/ml,肿瘤坏死因子降低0.96 pg/ml,益生菌干预恢复肝脂肪浸润度的相关风险为0.77。结论补充益生菌可能是干预NAFLD的一种有效方法。

Objective To summarize randomized controlled trials related to the improvement of non-alcoholic fatty liver disease(NAFLD)by probiotics and to analyze the effect of interventions.Methods Embase,Pubmed,Cochrance Library,Web of Science,CBM,CNKI,Wanfang and Wipu databases were searched for randomized controlled trials on the improvement of NAFLD by probiotics that were published between January 2007 and March 2021.Eligible studies were identified according to the inclusion and exclusion criteria.Results of randomized controlled trials were pooled using a random-effects model,and heterogeneity was assessed using statistical indicator I^(2).Results Nine randomized controlled trials involving 694 patients with NAFLD/NASH were included.Treatment with probiotics reduced ALT by 8.02 IU/L,AST by 5.34 IU/L,TC by 0.57 mmol/L,TG by 0.72 mmol/L,glucose by 0.21 mmol/L,HOMA-IR by 0.37,insulin by 3.06μU/ml,IL-6 by 0.25 pg/ml,and TNF-αby 0.96 pg/ml.The relative risk of the degree of liver fat infiltration was 0.77 after the treatment of probiotics.Conclusion Supplementation of probiotics may be an effective means in the intervention of NAFLD.