Efficacy of probiotics on nonalcoholic fatty liver disease: A meta-analysis

Medicine (Baltimore). 2023 Jan 27;102(4):e32734. doi: 10.1097/MD.0000000000032734.


Objectives: The intestinal flora is closely related to the pathogenesis of nonalcoholic fatty liver disease (NAFLD). This study intends to systematically evaluate the efficacy and safety of probiotics in the treatment of NAFLD through a meta-analysis of published randomized controlled trials.

Methods: This study was conducted through a search of published randomized controlled trials using probiotic-related drugs for the treatment of nonalcoholic fatty liver disease (up to April 6, 2022). The JADAD evaluation table was used to evaluate the quality of the literatures included in the search, and the risk of bias was evaluated according to the Cochrane evaluation manual. Finally, RevMan5.4 software was used for meta-analysis.

Results: A total of 21 randomized clinical trials involving 1037 patients with NAFLD were included in this study. Meta-analysis results showed that after probiotic intervention, liver function, blood lipid level, blood glucose levels and insulin levels were significantly reduced, which had a good effect on improving hepatic steatosis. However, it did not significantly improve BMI, inflammatory factors, or homeostasis model assessment of insulin resistance. Through the subgroup analysis of the course of treatment, it was found that ALT, GGT, TG, and blood sugar improved better in the probiotic treatment course of greater than or equal to 12 weeks.

Conclusion: This study shows that the use of probiotics therapy has a good regulating effect on liver function, steatosis, blood glucose level, insulin level and blood lipid level in NAFLD patients.

Publication types

  • Meta-Analysis

MeSH terms

  • Blood Glucose / analysis
  • Humans
  • Insulins*
  • Lipids
  • Liver / pathology
  • Non-alcoholic Fatty Liver Disease* / drug therapy
  • Probiotics* / therapeutic use
  • Randomized Controlled Trials as Topic


  • Blood Glucose
  • Lipids
  • Insulins