Year 2023 / Volume 115 / Number 8
Original
Probiotics and non-alcoholic fatty liver disease in children and adolescents: a systematic review

418-427

DOI: 10.17235/reed.2022.8796/2022

David Avelar-Rodríguez, Rubén Peña-Vélez, Jelena Popov, Lee Hill, Paul MacDaragh Ryan,

Abstract
Background: non-alcoholic fatty liver disease (NAFLD) in childhood is an increasing global public health issue 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 synthesize all the available literature on the use of probiotics in children and adolescents with NAFLD. Methods: PubMed, EBSCOhost, Scopus, Web of Science, and Cochrane Library were systematically searched 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: five randomized controlled trials met the inclusion criteria. Of these, four trials were included in the final quantitative analysis. Probiotic therapy significantly reduced the levels of alanine aminotransferase (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.
Lay Summary
Non-Alcoholic Fatty Liver Disease in childhood is an increasing public health issue globally with significant long-term consequences. Non-Alcoholic Fatty Liver Disease management mainly consists of lifestyle modifications, however, adjunct pharmacological therapies are currently lacking. Gut microbiota manipulation via probiotics may alter the course of pediatric Non-Alcoholic Fatty Liver Disease. 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 alanine amino transferase (mean difference, -10.39 [-19.85, -0.93]), however significant heterogeneity between studies was identified (I2, 93%). There is insufficient evidence to support probiotics in the treatment of pediatric Non-Alcoholic Fatty Liver Disease given the substantial degree of discordance amongst the available trials. Lifestyle modifications focusing on maintaining a normal body mass index and regular exercise continue to be the gold standard approach to treating Non-Alcoholic Fatty Liver Disease in children.
Share Button
New comment
Comments

09/08/2023 5:18:07
Donde encuentro el artículo en PDF en español?


Related articles

Letter

Encephalopathy in short bowel syndrome: a diagnostic challenge

DOI: 10.17235/reed.2022.8826/2022

Citation tools
Avelar-Rodríguez D, Peña-Vélez R, Popov J, Hill L, Ryan P. Probiotics and non-alcoholic fatty liver disease in children and adolescents: a systematic review. 8796/2022


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 2693 visits.
This article has been downloaded 186 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 17/03/2022

Accepted: 08/11/2022

Online First: 22/11/2022

Published: 26/07/2023

Article revision time: 165 days

Article Online First time: 250 days

Article editing time: 496 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2024 y Creative Commons. The Spanish Journal of Gastroenterology