Probiotics and non-alcoholic fatty liver disease in children and adolescents: a systematic review
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Accepted Version
Date
2022-11-22
Authors
Avelar-Rodríguez, David
Peña-Vélez, Rubén
Popov, Jelena
Hill, Lee
MacDaragh Ryan, Paul
Journal Title
Journal ISSN
Volume Title
Publisher
Sociedad Española de Patología Digestiva (SEPD)
Published Version
Abstract
Background: Non-Alcoholic Fatty Liver Disease (NAFLD) in childhood is an increasing public health issue globally with significant long-term consequences. NAFLD management mainly consists of lifestyle modifications, however, adjunct pharmacological therapies are currently lacking. Gut microbiota manipulation via probiotics may alter the course of pediatric NAFLD. The objective of this systematic review was to synthesise all the available literature on the use of probiotics in children and adolescents with NAFLD. Methods: We systematically searched PubMed, EBSCOhost, Scopus, Web of Science, and Cochrane Library for trials on the use of probiotics in pediatric NAFLD. A quantitative DerSimonian Laird random effects meta-analysis was performed when possible; otherwise, a narrative summary of the study outcomes was presented and discussed. A separate search was completed to include all the ongoing registered trials on probiotics use in pediatric NAFLD. Results: 5 randomized controlled trials met the inclusion criteria. Of these, 4 trials were included in the final quantitative analysis. Probiotic therapy significantly reduced the levels of ALT (mean difference, -10.39 [-19.85, -0.93]), however significant heterogeneity between studies was identified (I2, 93%). Conclusions: There is insufficient evidence to support probiotics in the treatment of pediatric NAFLD given the substantial degree of discordance amongst the available trials. Lifestyle modifications focusing on maintaining a normal BMI and regular exercise continue to be the gold standard approach to treating NAFLD in children.
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Keywords
Non-alcoholic fatty liver disease , NAFLD , Probiotics , Childhood obesity
Citation
Avelar-Rodríguez, D., Peña-Vélez, R., Popov, J., Hill, L., Ryan, P. M. (2022) 'Probiotics and non-alcoholic fatty liver disease in children and adolescents: a systematic review', Revista Española de Enfermedades Digestivas: Organo Oficial de la Sociedad Española de Patología Digestiva. doi: 10.17235/reed.2022.8796/2022
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© 2022, Sociedad Española de Patología Digestiva (SEPD) and © ARAN Ediciones, S. L. All rights reserved. Any part of this publication can be reproduced, transmitted in any electronic or mechanic form or means, including photocopies, recording or any system of information retrieval storage, without the written authorization of the owner of the Copyright.