Table 5.
The efficiency of probiotics, prebiotics, and synbiotics supplementation in NAFLD patients.
| Study | Preparate + Dosage | Group * | Diagnosis | Duration | Results ** | Possible Mechanism |
|---|---|---|---|---|---|---|
| Kobyliak et al. [213] (2018) | Symbiter (14 genera’s of probiotic species: Bifidobacterium, Lactobacillus, Lactococcus, and Propionibacterium) in dose 10 g per day | 58 patients with T2DM and NAFLD (30 in probiotic group) | USG | 8 weeks | ↓: FLI, AST, GGT, TNF-α, IL-6, TG | Improvements in intestinal microbiota and gut permeability; decrease in JNK activity in liver; reduction in inflammatory markers |
| Ahn et al. [215] (2019) | Probiotic composed with: Lactobacillus acidophilus, L. rhamnosus, L. paracasei, Pediococcus pentosaceus, Bifidobacterium lactis, and B. breve | 68 obese NAFLD patients (32 in probiotics group) | MRI | 12 weeks | ↓: IHF, TG However, after adjusting to BW changes, there were no differences between probiotic and placebo groups |
Correction of intestinal dysbiosis by production of lactic acids, promotion of molecular immunity, and changes in intestinal environment |
| Abhari et al. [218] (2020) | 109 Bacillus coagulans spore (GBI-30) plus 0.4 g inulin per day | 53 patients with NAFLD (22 in symbiotic group) | Fibroscan | 12 weeks | ↓: liver steatosis, ALT, GGT, TNF-α, NF-κB | Amelioration of inflammation by reducing pathogenic bacteria in gut and improving intestinal barrier |
| Eslamparast et al. [219] (2014) | Protexin containing 7 strains of bacteria: (Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, Lactobacillus acidophilus, Bifidobacterium longum, and Lactobacillus bulgaricus), fructooligosaccharide, probiotic cultures magnesium stearate and a vegetable capsule | 58 patients with NAFLD (26 in symbiotic group) | Fibroscan | 28 weeks | ↓: liver fibrosis score, TNF-α, NF-κB, hs-CRP, GGT, ALT, AST, | Modulation of intestinal microbiota; reduction in serum inflammatory cytokines levels; decrease in JNK and NF-κB activity; improvement in IR through decline of endotoxins and intestinal toxins levels and increasing pH of feces |
| Mofidi et al. [220] (2017) | Protexin (the composition same as line above) | 50 lean NAFLD patients (25 in symbiotic group) | Fibroscan | 28 weeks | ↓: liver fibrosis, liver steatosis, FPG, AST hs-CRP, NF-κB |
Abbreviations: ALP—alkaline phosphatase, ALT—alanine aminotransferase, AST—aspartate aminotransferase, BW—body weight, FLI—fatty liver index, FPG—fasting plasma glucose, GGT—γ-glutamyltranspeptidase, hs-CRP—high sensitive C-reactive protein IHF—intrahepatic fat, IL-6—interleukin 6, JNK—c-Jun N-terminal kinase, LDL-C—low density lipoprotein cholesterol, NF-κB—nuclear factor- κB, T2DM—type 2 diabetes mellitus, TG—triglycerides, TNF-α—tumor necrosis factor alpha, USG—ultrasonography. * In the group column, the number of respondents analyzed was given, not the people who were included in the study and for various reasons were excluded from it during procedures. ** Changes shown in results column are significant.