Prebiotics may reduce serum concentrations of C-reactive protein and ghrelin in overweight and obese adults: a systematic review and meta-analysis

Nutr Rev. 2020 Mar 1;78(3):235-248. doi: 10.1093/nutrit/nuz045.


Context: Biochemical markers correlate positively with the development and severity of obesity, depression, and anxiety, and can be modulated by changes in intestinal microbiota composition.

Objective: A systematic review and meta-analysis was conducted to determine the effects of prebiotics or synbiotics on blood biomarkers of obesity, depression, and anxiety (including: ACTH [adrenocorticotropic hormone], cortisol, leptin, ghrelin, TSH [thyroid-stimulating hormone], PTH [parathyroid hormone], vitamin D, BDNF [brain-derived neurotrophic factor], and PCR [polymerase chain reaction]) in individuals with overweight or obesity.

Data sources: MEDLINE, Web of Science, Scopus, and CENTRAL databases were searched, along with the reference lists of included articles. Authors were contacted for unpublished data.

Study selection: RCT in individuals with overweight or obesity, supplemented with prebiotics or synbiotics, assessing any of the outcomes of interest.

Data extraction: Data were extracted independently by three researchers.

Results: Thirteen studies were identified up to March 7, 2018. Regarding outcomes, 1 study assessed leptin, 4 studies assessed ghrelin, and 10 studies assessed CRP (C-reactive protein). Meta-analysis showed reduction in serum concentrations of ghrelin (-37.17 pg/mL; 95%CI = -69.62, -4.73; P = 0.025) and CRP (SMD [standardized mean difference] = -0.31; 95%CI = -0.58, -0.04; P = 0.027) after supplementation of inulin-type fructans.

Conclusions: Prebiotics may help regulate blood concentrations of ghrelin and CRP in overweight or obese individuals.

Keywords: C-reactive protein; ghrelin; obesity; prebiotics; synbiotics.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • Adrenocorticotropic Hormone / blood
  • Adult
  • Aged
  • Biomarkers / blood
  • C-Reactive Protein / analysis*
  • Gastrointestinal Microbiome
  • Ghrelin / blood*
  • Humans
  • Hydrocortisone / blood
  • Leptin / blood
  • Middle Aged
  • Obesity / blood
  • Obesity / diet therapy
  • Overweight / blood*
  • Overweight / diet therapy*
  • Prebiotics*
  • Synbiotics
  • Vitamin D / blood
  • Young Adult


  • Biomarkers
  • Ghrelin
  • Leptin
  • Prebiotics
  • Vitamin D
  • Adrenocorticotropic Hormone
  • C-Reactive Protein
  • Hydrocortisone