Impact of bacterial probiotics on obesity, diabetes and non-alcoholic fatty liver disease related variables: a systematic review and meta-analysis of randomised controlled trials
ObjectiveTo systematically review the effect of oral intake of bacterial probiotics on 15 variables related to obesity, diabetes and non-alcoholic fatty liver disease.DesignSystematic review and meta-analysis.Data sourcesMedline, EMBASE and COCHRANE from 1990 to June 2018.Eligibility criteriaRandomi...
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Published in | BMJ open Vol. 9; no. 3; p. e017995 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
BMJ Publishing Group LTD
30.03.2019
BMJ Publishing Group |
Subjects | |
Online Access | Get full text |
ISSN | 2044-6055 2044-6055 |
DOI | 10.1136/bmjopen-2017-017995 |
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Abstract | ObjectiveTo systematically review the effect of oral intake of bacterial probiotics on 15 variables related to obesity, diabetes and non-alcoholic fatty liver disease.DesignSystematic review and meta-analysis.Data sourcesMedline, EMBASE and COCHRANE from 1990 to June 2018.Eligibility criteriaRandomised controlled trials (≥14 days) excluding hypercholesterolaemia, alcoholic liver disease, polycystic ovary syndrome and children <3 years.ResultsOne hundred and five articles met inclusion criteria, representing 6826 subjects. In overweight but not obese subjects, probiotics induced improvements in: body weight (k=25 trials, d=−0.94 kg mean difference, 95% CI −1.17 to −0.70, I²=0.0%), body mass index (k=32, d=−0.55 kg/m², 95% CI −0.86 to −0.23, I²=91.9%), waist circumference (k=13, d=−1.31 cm, 95% CI −1.79 to −0.83, I²=14.5%), body fat mass (k=11, d=−0.96 kg, 95% CI −1.21 to −0.71, I²=0.0%) and visceral adipose tissue mass (k=5, d=−6.30 cm², 95% CI −9.05 to −3.56, I²=0.0%). In type 2 diabetics, probiotics reduced fasting glucose (k=19, d=−0.66 mmol/L, 95% CI −1.00 to −0.31, I²=27.7%), glycated haemoglobin (k=13, d=−0.28 pp, 95% CI −0.46 to −0.11, I²=54.1%), insulin (k=13, d=−1.66 mU/L, 95% CI −2.70 to −0.61, I²=37.8%) and homeostatic model of insulin resistance (k=10, d=−1.05 pp, 95% CI −1.48 to −0.61, I²=18.2%). In subjects with fatty liver diseases, probiotics reduced alanine (k=12, d=−10.2 U/L, 95% CI −14.3 to −6.0, I²=93.50%) and aspartate aminotransferases (k=10, d=−9.9 U/L, 95% CI −14.1 to -5.8, I²=96.1%). These improvements were mostly observed with bifidobacteria (Bifidobacterium breve, B. longum), Streptococcus salivarius subsp. thermophilus and lactobacilli (Lactobacillus acidophilus, L. casei, L. delbrueckii) containing mixtures and influenced by trials conducted in one country.ConclusionsThe intake of probiotics resulted in minor but consistent improvements in several metabolic risk factors in subjects with metabolic diseases.Trial registration numberCRD42016033273. |
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AbstractList | To systematically review the effect of oral intake of bacterial probiotics on 15 variables related to obesity, diabetes and non-alcoholic fatty liver disease.OBJECTIVETo systematically review the effect of oral intake of bacterial probiotics on 15 variables related to obesity, diabetes and non-alcoholic fatty liver disease.Systematic review and meta-analysis.DESIGNSystematic review and meta-analysis.Medline, EMBASE and COCHRANE from 1990 to June 2018.DATA SOURCESMedline, EMBASE and COCHRANE from 1990 to June 2018.Randomised controlled trials (≥14 days) excluding hypercholesterolaemia, alcoholic liver disease, polycystic ovary syndrome and children <3 years.ELIGIBILITY CRITERIARandomised controlled trials (≥14 days) excluding hypercholesterolaemia, alcoholic liver disease, polycystic ovary syndrome and children <3 years.One hundred and five articles met inclusion criteria, representing 6826 subjects. In overweight but not obese subjects, probiotics induced improvements in: body weight (k=25 trials, d=-0.94 kg mean difference, 95% CI -1.17 to -0.70, I²=0.0%), body mass index (k=32, d=-0.55 kg/m², 95% CI -0.86 to -0.23, I²=91.9%), waist circumference (k=13, d=-1.31 cm, 95% CI -1.79 to -0.83, I²=14.5%), body fat mass (k=11, d=-0.96 kg, 95% CI -1.21 to -0.71, I²=0.0%) and visceral adipose tissue mass (k=5, d=-6.30 cm², 95% CI -9.05 to -3.56, I²=0.0%). In type 2 diabetics, probiotics reduced fasting glucose (k=19, d=-0.66 mmol/L, 95% CI -1.00 to -0.31, I²=27.7%), glycated haemoglobin (k=13, d=-0.28 pp, 95% CI -0.46 to -0.11, I²=54.1%), insulin (k=13, d=-1.66 mU/L, 95% CI -2.70 to -0.61, I²=37.8%) and homeostatic model of insulin resistance (k=10, d=-1.05 pp, 95% CI -1.48 to -0.61, I²=18.2%). In subjects with fatty liver diseases, probiotics reduced alanine (k=12, d=-10.2 U/L, 95% CI -14.3 to -6.0, I²=93.50%) and aspartate aminotransferases (k=10, d=-9.9 U/L, 95% CI -14.1 to -5.8, I²=96.1%). These improvements were mostly observed with bifidobacteria (Bifidobacterium breve, B. longum), Streptococcus salivarius subsp. thermophilus and lactobacilli (Lactobacillus acidophilus, L. casei, L. delbrueckii) containing mixtures and influenced by trials conducted in one country.RESULTSOne hundred and five articles met inclusion criteria, representing 6826 subjects. In overweight but not obese subjects, probiotics induced improvements in: body weight (k=25 trials, d=-0.94 kg mean difference, 95% CI -1.17 to -0.70, I²=0.0%), body mass index (k=32, d=-0.55 kg/m², 95% CI -0.86 to -0.23, I²=91.9%), waist circumference (k=13, d=-1.31 cm, 95% CI -1.79 to -0.83, I²=14.5%), body fat mass (k=11, d=-0.96 kg, 95% CI -1.21 to -0.71, I²=0.0%) and visceral adipose tissue mass (k=5, d=-6.30 cm², 95% CI -9.05 to -3.56, I²=0.0%). In type 2 diabetics, probiotics reduced fasting glucose (k=19, d=-0.66 mmol/L, 95% CI -1.00 to -0.31, I²=27.7%), glycated haemoglobin (k=13, d=-0.28 pp, 95% CI -0.46 to -0.11, I²=54.1%), insulin (k=13, d=-1.66 mU/L, 95% CI -2.70 to -0.61, I²=37.8%) and homeostatic model of insulin resistance (k=10, d=-1.05 pp, 95% CI -1.48 to -0.61, I²=18.2%). In subjects with fatty liver diseases, probiotics reduced alanine (k=12, d=-10.2 U/L, 95% CI -14.3 to -6.0, I²=93.50%) and aspartate aminotransferases (k=10, d=-9.9 U/L, 95% CI -14.1 to -5.8, I²=96.1%). These improvements were mostly observed with bifidobacteria (Bifidobacterium breve, B. longum), Streptococcus salivarius subsp. thermophilus and lactobacilli (Lactobacillus acidophilus, L. casei, L. delbrueckii) containing mixtures and influenced by trials conducted in one country.The intake of probiotics resulted in minor but consistent improvements in several metabolic risk factors in subjects with metabolic diseases.CONCLUSIONSThe intake of probiotics resulted in minor but consistent improvements in several metabolic risk factors in subjects with metabolic diseases.CRD42016033273.TRIAL REGISTRATION NUMBERCRD42016033273. To systematically review the effect of oral intake of bacterial probiotics on 15 variables related to obesity, diabetes and non-alcoholic fatty liver disease. Systematic review and meta-analysis. Medline, EMBASE and COCHRANE from 1990 to June 2018. Randomised controlled trials (≥14 days) excluding hypercholesterolaemia, alcoholic liver disease, polycystic ovary syndrome and children <3 years. One hundred and five articles met inclusion criteria, representing 6826 subjects. In overweight but not obese subjects, probiotics induced improvements in: body weight (k=25 trials, d=-0.94 kg mean difference, 95% CI -1.17 to -0.70, I²=0.0%), body mass index (k=32, d=-0.55 kg/m², 95% CI -0.86 to -0.23, I²=91.9%), waist circumference (k=13, d=-1.31 cm, 95% CI -1.79 to -0.83, I²=14.5%), body fat mass (k=11, d=-0.96 kg, 95% CI -1.21 to -0.71, I²=0.0%) and visceral adipose tissue mass (k=5, d=-6.30 cm², 95% CI -9.05 to -3.56, I²=0.0%). In type 2 diabetics, probiotics reduced fasting glucose (k=19, d=-0.66 mmol/L, 95% CI -1.00 to -0.31, I²=27.7%), glycated haemoglobin (k=13, d=-0.28 pp, 95% CI -0.46 to -0.11, I²=54.1%), insulin (k=13, d=-1.66 mU/L, 95% CI -2.70 to -0.61, I²=37.8%) and homeostatic model of insulin resistance (k=10, d=-1.05 pp, 95% CI -1.48 to -0.61, I²=18.2%). In subjects with fatty liver diseases, probiotics reduced alanine (k=12, d=-10.2 U/L, 95% CI -14.3 to -6.0, I²=93.50%) and aspartate aminotransferases (k=10, d=-9.9 U/L, 95% CI -14.1 to -5.8, I²=96.1%). These improvements were mostly observed with bifidobacteria ( , ), subsp and lactobacilli ( , , ) containing mixtures and influenced by trials conducted in one country. The intake of probiotics resulted in minor but consistent improvements in several metabolic risk factors in subjects with metabolic diseases. CRD42016033273. ObjectiveTo systematically review the effect of oral intake of bacterial probiotics on 15 variables related to obesity, diabetes and non-alcoholic fatty liver disease.DesignSystematic review and meta-analysis.Data sourcesMedline, EMBASE and COCHRANE from 1990 to June 2018.Eligibility criteriaRandomised controlled trials (≥14 days) excluding hypercholesterolaemia, alcoholic liver disease, polycystic ovary syndrome and children <3 years.ResultsOne hundred and five articles met inclusion criteria, representing 6826 subjects. In overweight but not obese subjects, probiotics induced improvements in: body weight (k=25 trials, d=−0.94 kg mean difference, 95% CI −1.17 to −0.70, I²=0.0%), body mass index (k=32, d=−0.55 kg/m², 95% CI −0.86 to −0.23, I²=91.9%), waist circumference (k=13, d=−1.31 cm, 95% CI −1.79 to −0.83, I²=14.5%), body fat mass (k=11, d=−0.96 kg, 95% CI −1.21 to −0.71, I²=0.0%) and visceral adipose tissue mass (k=5, d=−6.30 cm², 95% CI −9.05 to −3.56, I²=0.0%). In type 2 diabetics, probiotics reduced fasting glucose (k=19, d=−0.66 mmol/L, 95% CI −1.00 to −0.31, I²=27.7%), glycated haemoglobin (k=13, d=−0.28 pp, 95% CI −0.46 to −0.11, I²=54.1%), insulin (k=13, d=−1.66 mU/L, 95% CI −2.70 to −0.61, I²=37.8%) and homeostatic model of insulin resistance (k=10, d=−1.05 pp, 95% CI −1.48 to −0.61, I²=18.2%). In subjects with fatty liver diseases, probiotics reduced alanine (k=12, d=−10.2 U/L, 95% CI −14.3 to −6.0, I²=93.50%) and aspartate aminotransferases (k=10, d=−9.9 U/L, 95% CI −14.1 to -5.8, I²=96.1%). These improvements were mostly observed with bifidobacteria (Bifidobacterium breve, B. longum), Streptococcus salivarius subsp. thermophilus and lactobacilli (Lactobacillus acidophilus, L. casei, L. delbrueckii) containing mixtures and influenced by trials conducted in one country.ConclusionsThe intake of probiotics resulted in minor but consistent improvements in several metabolic risk factors in subjects with metabolic diseases.Trial registration numberCRD42016033273. OBJECTIVE: To systematically review the effect of oral intake of bacterial probiotics on 15 variables related to obesity, diabetes and non-alcoholic fatty liver disease.DESIGN: Systematic review and meta-analysis.DATA SOURCES: Medline, EMBASE and COCHRANE from 1990 to June 2018.ELIGIBILITY CRITERIA: Randomised controlled trials (≥14 days) excluding hypercholesterolaemia, alcoholic liver disease, polycystic ovary syndrome and children <3 years.RESULTS: One hundred and five articles met inclusion criteria, representing 6826 subjects. In overweight but not obese subjects, probiotics induced improvements in: body weight (k=25 trials, d=-0.94 kg mean difference, 95% CI -1.17 to -0.70, I²=0.0%), body mass index (k=32, d=-0.55 kg/m², 95% CI -0.86 to -0.23, I²=91.9%), waist circumference (k=13, d=-1.31 cm, 95% CI -1.79 to -0.83, I²=14.5%), body fat mass (k=11, d=-0.96 kg, 95% CI -1.21 to -0.71, I²=0.0%) and visceral adipose tissue mass (k=5, d=-6.30 cm², 95% CI -9.05 to -3.56, I²=0.0%). In type 2 diabetics, probiotics reduced fasting glucose (k=19, d=-0.66 mmol/L, 95% CI -1.00 to -0.31, I²=27.7%), glycated haemoglobin (k=13, d=-0.28 pp, 95% CI -0.46 to -0.11, I²=54.1%), insulin (k=13, d=-1.66 mU/L, 95% CI -2.70 to -0.61, I²=37.8%) and homeostatic model of insulin resistance (k=10, d=-1.05 pp, 95% CI -1.48 to -0.61, I²=18.2%). In subjects with fatty liver diseases, probiotics reduced alanine (k=12, d=-10.2 U/L, 95% CI -14.3 to -6.0, I²=93.50%) and aspartate aminotransferases (k=10, d=-9.9 U/L, 95% CI -14.1 to -5.8, I²=96.1%). These improvements were mostly observed with bifidobacteria (Bifidobacterium breve, B. longum), Streptococcus salivarius subsp. thermophilus and lactobacilli (Lactobacillus acidophilus, L. casei, L. delbrueckii) containing mixtures and influenced by trials conducted in one country.CONCLUSIONS: The intake of probiotics resulted in minor but consistent improvements in several metabolic risk factors in subjects with metabolic diseases. |
Author | Koutnikova, Hana Schrezenmeir, Jürgen Faurie, Jean-Michel Genser, Bernd Clément, Karine Monteiro-Sepulveda, Milena Rizkalla, Salwa |
AuthorAffiliation | 6 Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), NutriOmiCs team , UMR S 1269 , Paris , France 4 Nutrition Department , Pitie-Salpêtrière hospital, Institute of Cardiometabolism and Nutrition, Assistance Publique-Hôpitaux de Paris , Paris , France 5 Clinical Research Center Kiel , Johannes Gutenberg Universitat Universitatsmedizin , Mainz , Rheinland-Pfalz , Germany 1 Danone Nutricia Research , Palaiseau , France 2 BGStats Consulting , Vienna , Austria 3 Mannheimer Institut fur Public Health , Ruprecht Karls Universitat Heidelberg , Mannheim , Baden-Württemberg , Germany |
AuthorAffiliation_xml | – name: 1 Danone Nutricia Research , Palaiseau , France – name: 6 Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), NutriOmiCs team , UMR S 1269 , Paris , France – name: 3 Mannheimer Institut fur Public Health , Ruprecht Karls Universitat Heidelberg , Mannheim , Baden-Württemberg , Germany – name: 2 BGStats Consulting , Vienna , Austria – name: 4 Nutrition Department , Pitie-Salpêtrière hospital, Institute of Cardiometabolism and Nutrition, Assistance Publique-Hôpitaux de Paris , Paris , France – name: 5 Clinical Research Center Kiel , Johannes Gutenberg Universitat Universitatsmedizin , Mainz , Rheinland-Pfalz , Germany |
Author_xml | – sequence: 1 givenname: Hana surname: Koutnikova fullname: Koutnikova, Hana email: karine.clement@psl.aphp.fr organization: Danone Nutricia Research, Palaiseau, France – sequence: 2 givenname: Bernd surname: Genser fullname: Genser, Bernd email: karine.clement@psl.aphp.fr organization: Mannheimer Institut fur Public Health, Ruprecht Karls Universitat Heidelberg, Mannheim, Baden-Württemberg, Germany – sequence: 3 givenname: Milena surname: Monteiro-Sepulveda fullname: Monteiro-Sepulveda, Milena email: karine.clement@psl.aphp.fr organization: Nutrition Department, Pitie-Salpêtrière hospital, Institute of Cardiometabolism and Nutrition, Assistance Publique-Hôpitaux de Paris, Paris, France – sequence: 4 givenname: Jean-Michel surname: Faurie fullname: Faurie, Jean-Michel email: karine.clement@psl.aphp.fr organization: Danone Nutricia Research, Palaiseau, France – sequence: 5 givenname: Salwa surname: Rizkalla fullname: Rizkalla, Salwa email: karine.clement@psl.aphp.fr organization: Nutrition Department, Pitie-Salpêtrière hospital, Institute of Cardiometabolism and Nutrition, Assistance Publique-Hôpitaux de Paris, Paris, France – sequence: 6 givenname: Jürgen surname: Schrezenmeir fullname: Schrezenmeir, Jürgen email: karine.clement@psl.aphp.fr organization: Clinical Research Center Kiel, Johannes Gutenberg Universitat Universitatsmedizin, Mainz, Rheinland-Pfalz, Germany – sequence: 7 givenname: Karine orcidid: 0000-0003-4619-6785 surname: Clément fullname: Clément, Karine email: karine.clement@psl.aphp.fr organization: Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), NutriOmiCs team, UMR S , Paris, France |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30928918$$D View this record in MEDLINE/PubMed https://hal.sorbonne-universite.fr/hal-02165922$$DView record in HAL |
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44 2024051615022080000_9.3.e017995.131 2024051615022080000_9.3.e017995.134 2024051615022080000_9.3.e017995.133 Mozaffarian (2024051615022080000_9.3.e017995.132) 2011; 364 Yao (2024051615022080000_9.3.e017995.17) 2017; 23 Naito (2024051615022080000_9.3.e017995.103) 2018; 37 2024051615022080000_9.3.e017995.139 2024051615022080000_9.3.e017995.19 Hajifaraji (2024051615022080000_9.3.e017995.60) 2018; 27 2024051615022080000_9.3.e017995.130 2024051615022080000_9.3.e017995.14 2024051615022080000_9.3.e017995.15 Mohamadshahi (2024051615022080000_9.3.e017995.99) 2014; 4 2024051615022080000_9.3.e017995.13 Behrouz (2024051615022080000_9.3.e017995.42) 2017; 9 2024051615022080000_9.3.e017995.98 2024051615022080000_9.3.e017995.11 2024051615022080000_9.3.e017995.96 2024051615022080000_9.3.e017995.127 2024051615022080000_9.3.e017995.97 Sabico (2024051615022080000_9.3.e017995.112) 2017; 15 2024051615022080000_9.3.e017995.126 Badehnoosh (2024051615022080000_9.3.e017995.39) 2018; 31 2024051615022080000_9.3.e017995.120 Firouzi (2024051615022080000_9.3.e017995.57) 2015; 15 2024051615022080000_9.3.e017995.91 Jafarnejad (2024051615022080000_9.3.e017995.71) 2016; 2016 2024051615022080000_9.3.e017995.129 Osterberg (2024051615022080000_9.3.e017995.109) 2015; 23 2024051615022080000_9.3.e017995.9 Tajabadi-Ebrahimi (2024051615022080000_9.3.e017995.123) 2017; 125 2024051615022080000_9.3.e017995.8 Eslamparast (2024051615022080000_9.3.e017995.53) 2014; 112 2024051615022080000_9.3.e017995.2 2024051615022080000_9.3.e017995.1 2024051615022080000_9.3.e017995.28 2024051615022080000_9.3.e017995.6 2024051615022080000_9.3.e017995.25 2024051615022080000_9.3.e017995.5 2024051615022080000_9.3.e017995.4 2024051615022080000_9.3.e017995.23 2024051615022080000_9.3.e017995.3 2024051615022080000_9.3.e017995.24 2024051615022080000_9.3.e017995.21 2024051615022080000_9.3.e017995.114 2024051615022080000_9.3.e017995.22 2024051615022080000_9.3.e017995.113 Javadi (2024051615022080000_9.3.e017995.74) 2017; 4 2024051615022080000_9.3.e017995.20 2024051615022080000_9.3.e017995.110 Akbari (2024051615022080000_9.3.e017995.29) 2016; 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28 Ibrahim (2024051615022080000_9.3.e017995.67) 2018; 43 (2024051615022080000_9.3.e017995.18) 2018; 16 2024051615022080000_9.3.e017995.69 Naruszewicz (2024051615022080000_9.3.e017995.104) 2002; 76 2024051615022080000_9.3.e017995.68 2024051615022080000_9.3.e017995.65 Odamaki (2024051615022080000_9.3.e017995.105) 2016; 7 2024051615022080000_9.3.e017995.64 2024051615022080000_9.3.e017995.62 Wang (2024051615022080000_9.3.e017995.16) 2017; 30 |
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Snippet | ObjectiveTo systematically review the effect of oral intake of bacterial probiotics on 15 variables related to obesity, diabetes and non-alcoholic fatty liver... To systematically review the effect of oral intake of bacterial probiotics on 15 variables related to obesity, diabetes and non-alcoholic fatty liver disease.... To systematically review the effect of oral intake of bacterial probiotics on 15 variables related to obesity, diabetes and non-alcoholic fatty liver... OBJECTIVE: To systematically review the effect of oral intake of bacterial probiotics on 15 variables related to obesity, diabetes and non-alcoholic fatty... |
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SubjectTerms | Clinical trials Diabetes Diabetes Mellitus - metabolism Diabetes Mellitus - therapy Dietary Supplements Endocrinology and metabolism Evidence-based medicine Fatty liver Food and Nutrition Human health and pathology Humans Insulin resistance Life Sciences Liver diseases Meta-analysis Non-alcoholic Fatty Liver Disease - metabolism Non-alcoholic Fatty Liver Disease - therapy Nutrition and Metabolism Obesity Obesity - metabolism Obesity - therapy Probiotics Probiotics - pharmacology Randomized Controlled Trials as Topic Santé publique et épidémiologie Systematic review Treatment Outcome |
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Title | Impact of bacterial probiotics on obesity, diabetes and non-alcoholic fatty liver disease related variables: a systematic review and meta-analysis of randomised controlled trials |
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