The Relationship between Prebiotic Supplementation and Anthropometric and Biochemical Parameters in Patients with NAFLD—A Systematic Review and Meta-Analysis of Randomized Controlled Trials

We aim to systematically review the efficacy of prebiotics in reducing anthropometric and biochemical parameters in individuals with non-alcoholic fatty liver disease (NAFLD). A systematic search using PubMed/MEDLINE, Embase, clinicaltrials.gov, Cinahl, and Web of Science of articles published up to...

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Main Authors: Ewa Stachowska, Piero Portincasa, Dominika Jamioł-Milc, Dominika Maciejewska-Markiewicz, Karolina Skonieczna-Żydecka
Format: Article
Language:English
Published: MDPI AG 2020-11-01
Series:Nutrients
Subjects:
Online Access:https://www.mdpi.com/2072-6643/12/11/3460
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author Ewa Stachowska
Piero Portincasa
Dominika Jamioł-Milc
Dominika Maciejewska-Markiewicz
Karolina Skonieczna-Żydecka
author_facet Ewa Stachowska
Piero Portincasa
Dominika Jamioł-Milc
Dominika Maciejewska-Markiewicz
Karolina Skonieczna-Żydecka
author_sort Ewa Stachowska
collection DOAJ
description We aim to systematically review the efficacy of prebiotics in reducing anthropometric and biochemical parameters in individuals with non-alcoholic fatty liver disease (NAFLD). A systematic search using PubMed/MEDLINE, Embase, clinicaltrials.gov, Cinahl, and Web of Science of articles published up to 20 March 2020 was performed for randomized controlled trials enrolling >20 adult patients. Random-effect meta-analysis for metabolic outcomes in NAFLD patients was performed for anthropometric data in addition to liver enzyme, carbohydrate, and lipid parameters. We found six trials (comprising a total of 242 patients) with NAFLD, with subjects aged 38–52 years. The mean time of fiber administration varied between 10 and 12 weeks. The main fiber types were psyllium (seeds or powder), <i>Ocimum basilicum</i> (seeds), and high-performance inulin and oligofructose powder at doses of either 10 or 16 g per day. The control group received either maltodextrin (powder or capsules) or crushed wheat (powder). Patients on the diet with added fiber had improvements in body mass index (BMI) (standardized mean difference (SMD) = −0.494, 95% confidence interval (CI): −0.864 to −0.125, <i>p</i> = 0.009); alanine aminotransferase (ALT) (SMD = −0.667, 95% CI: −1.046 to −0.288, <i>p</i> = 0.001); aspartate aminotransferase (AST) (SMD = −0.466, 95% CI: −0.840 to −0.091, <i>p</i> = 0.015); fasting insulin (SMD = −0.705, 95% CI: −1.115 to −0.295, <i>p</i> = 0.001); and homeostasis model assessment for insulin resistance (HOMA-IR) (SMD = −0.619, 95% CI: −1.026 to −0.211, <i>p</i> = 0.003). Hence, the results show that fiber supplements result in favorable changes as reflected in the measurement of anthropometric, metabolic, and liver-related biomarkers, i.e., body mass index (BMI), homeostasis model assessment for insulin resistance (HOMA-IR), insulin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST). These effects suggest the potential benefits of fiber consumption for NAFLD populations. More prospective, controlled studies should be conducted to reveal specific details regarding the fiber type, dosage, and duration for optimal intervention.
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spelling doaj.art-85764492287f4bf2ab2d98621c21dd022023-11-20T20:35:18ZengMDPI AGNutrients2072-66432020-11-011211346010.3390/nu12113460The Relationship between Prebiotic Supplementation and Anthropometric and Biochemical Parameters in Patients with NAFLD—A Systematic Review and Meta-Analysis of Randomized Controlled TrialsEwa Stachowska0Piero Portincasa1Dominika Jamioł-Milc2Dominika Maciejewska-Markiewicz3Karolina Skonieczna-Żydecka4Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, PolandClinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, 70124 Bari, ItalyDepartment of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, PolandDepartment of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, PolandDepartment of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, PolandWe aim to systematically review the efficacy of prebiotics in reducing anthropometric and biochemical parameters in individuals with non-alcoholic fatty liver disease (NAFLD). A systematic search using PubMed/MEDLINE, Embase, clinicaltrials.gov, Cinahl, and Web of Science of articles published up to 20 March 2020 was performed for randomized controlled trials enrolling >20 adult patients. Random-effect meta-analysis for metabolic outcomes in NAFLD patients was performed for anthropometric data in addition to liver enzyme, carbohydrate, and lipid parameters. We found six trials (comprising a total of 242 patients) with NAFLD, with subjects aged 38–52 years. The mean time of fiber administration varied between 10 and 12 weeks. The main fiber types were psyllium (seeds or powder), <i>Ocimum basilicum</i> (seeds), and high-performance inulin and oligofructose powder at doses of either 10 or 16 g per day. The control group received either maltodextrin (powder or capsules) or crushed wheat (powder). Patients on the diet with added fiber had improvements in body mass index (BMI) (standardized mean difference (SMD) = −0.494, 95% confidence interval (CI): −0.864 to −0.125, <i>p</i> = 0.009); alanine aminotransferase (ALT) (SMD = −0.667, 95% CI: −1.046 to −0.288, <i>p</i> = 0.001); aspartate aminotransferase (AST) (SMD = −0.466, 95% CI: −0.840 to −0.091, <i>p</i> = 0.015); fasting insulin (SMD = −0.705, 95% CI: −1.115 to −0.295, <i>p</i> = 0.001); and homeostasis model assessment for insulin resistance (HOMA-IR) (SMD = −0.619, 95% CI: −1.026 to −0.211, <i>p</i> = 0.003). Hence, the results show that fiber supplements result in favorable changes as reflected in the measurement of anthropometric, metabolic, and liver-related biomarkers, i.e., body mass index (BMI), homeostasis model assessment for insulin resistance (HOMA-IR), insulin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST). These effects suggest the potential benefits of fiber consumption for NAFLD populations. More prospective, controlled studies should be conducted to reveal specific details regarding the fiber type, dosage, and duration for optimal intervention.https://www.mdpi.com/2072-6643/12/11/3460fiberprebioticNAFLDmeta-analysis
spellingShingle Ewa Stachowska
Piero Portincasa
Dominika Jamioł-Milc
Dominika Maciejewska-Markiewicz
Karolina Skonieczna-Żydecka
The Relationship between Prebiotic Supplementation and Anthropometric and Biochemical Parameters in Patients with NAFLD—A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Nutrients
fiber
prebiotic
NAFLD
meta-analysis
title The Relationship between Prebiotic Supplementation and Anthropometric and Biochemical Parameters in Patients with NAFLD—A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_full The Relationship between Prebiotic Supplementation and Anthropometric and Biochemical Parameters in Patients with NAFLD—A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_fullStr The Relationship between Prebiotic Supplementation and Anthropometric and Biochemical Parameters in Patients with NAFLD—A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_full_unstemmed The Relationship between Prebiotic Supplementation and Anthropometric and Biochemical Parameters in Patients with NAFLD—A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_short The Relationship between Prebiotic Supplementation and Anthropometric and Biochemical Parameters in Patients with NAFLD—A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_sort relationship between prebiotic supplementation and anthropometric and biochemical parameters in patients with nafld a systematic review and meta analysis of randomized controlled trials
topic fiber
prebiotic
NAFLD
meta-analysis
url https://www.mdpi.com/2072-6643/12/11/3460
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