The Effects of Gut Microbiome Manipulation on Glycemic Indices in Patients With Non-Alcoholic Fatty Liver Disease: A Comprehensive Umbrella Review Publisher Pubmed



Vakilpour A¹ ; Aminisalehi E² ; Soltani Moghadam A³ ; Keivanlou MH^{2, 4} ; Letafatkar N^{2, 4} ; Habibi A^{2, 4} ; Hashemi M⁵ ; Eslami N² ; Zare R⁶ ; Norouzi N² ; Delam H⁶ ; Joukar F² ; Mansourghanaei F² ; Hassanipour S² Show All Authors Show Affiliations
Source: Nutrition and Diabetes Published:2024

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. © The Author(s) 2024.