Synbiotic supplementation in lean patients with non-alcoholic fatty liver disease: a pilot, randomised, double-blind, placebo-controlled, clinical trial

Br J Nutr. 2017 Mar;117(5):662-668. doi: 10.1017/S0007114517000204. Epub 2017 Mar 27.


Although non-alcoholic fatty liver disease (NAFLD) is the leading aetiology of liver disorders in the world, there is no proven treatment for NAFLD patients with normal or low BMI. The aim of this study was to evaluate the efficacy of synbiotics supplementation in NAFLD patients with normal or low BMI. In this randomised, double-blind, placebo-controlled, clinical trial, fifty patients with NAFLD were assigned to take either a synbiotic supplement or a placebo capsule for 28 weeks. Both groups were advised to follow a healthy lifestyle. At the end of the study, hepatic steatosis and fibrosis reduced in both groups; however, the mean reduction was significantly greater in the synbiotic group rather than in the placebo group (P<0·001). Furthermore, serum levels of fasting blood sugar, TAG and most of the inflammatory mediators reduced in the synbiotic group significantly compared with the placebo group (P<0·05). Our results provide evidence that synbiotic supplementation improves the main features of NAFLD in patients with normal and low BMI, at least partially through reduction in inflammatory indices. Further studies are needed to address the exact mechanism of action of these effects.

Keywords: NAFLD non-alcoholic fatty liver disease; Body weight; Fatty liver; Non-alcoholic fatty liver diseases; Non-alcoholic steatohepatitis; Prebiotics; Probiotics; Synbiotics.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • Body Mass Index*
  • Dietary Supplements
  • Double-Blind Method
  • Female
  • Humans
  • Inflammation / therapy
  • Liver / pathology
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / pathology
  • Non-alcoholic Fatty Liver Disease / therapy*
  • Placebos
  • Synbiotics / administration & dosage*
  • Treatment Outcome
  • Triglycerides / blood


  • Blood Glucose
  • Placebos
  • Triglycerides