The effects of synbiotics on the liver steatosis, inflammation, and gut microbiome of metabolic dysfunction-associated liver disease patients-randomized trial
What this study found
The synbiotic improved liver steatosis and inflammation and favorably shifted the gut microbiome and gut transit time. Liver steatosis by pSWE/ATT decreased more with synbiotics than placebo (ΔATT -0.016±0.021 vs -0.006±0.023; p=0.046), and hs-CRP also fell more in the active arm (Δ -0.7 mg/L vs 0 mg/L; p≤0.001). Gut transit time improved more with synbiotics (Δ -10 h vs -5 h; p=0.031), with reported microbiome enrichment of Lactobacillus 81%, Bifidobacterium 55%, Faecalibacterium 51%, Streptococcus 40%, Ruminococcus -35%, and Enterobacterium -40%. Two patients reported increased flatulence,…
- Study & population
- Double-blind, randomized, placebo-controlled trial in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) from Belgrade, Serbia.
- Intervention
- Oral synbiotic capsules for 12 weeks containing Lactobacillus acidophilus CBT LA1, Lactobacillus casei CBT LC5, and Bifidobacterium lactis CBT BL3, with a total of 64 x 10^9 CFU per dose (16 x 10^9, 16 x 10^9, and 32 x 10^9 CFU, respectively) plus 6.4 g inulin.
- Key limitation
- Small sample size, with only 41 analyzed from 49 randomized, limits precision and generalizability.
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Open PDFOriginal abstract
Abstract Introduction: Metabolic Dysfunction-associated Liver Disease (MASLD) represents a spectrum of conditions from simple fat accumulation to non-alcoholic steatohepatitis. The possible role of the intestinal microbiome on MASLD development has been in focus. Our study aimed to examine the effects of synbiotics on the liver steatosis, inflammation, and stool microbiome. Methods: A double-blind, placebo-controlled study was conducted involving 84 MASLD patients, defined by an elastometric attenuation coefficient (ATT) greater than 0.63 dB/cm/MHz with an alanine aminotransferase level above 40 U/L for men and 35 U/L for women. The patients were divided into an intervention group treated with a synbiotic with 64x109 CFU of Lactobacillus and Bifidobacterium and 6.4g of inulin and a control group treated with a placebo. Results: Using synbiotics for 12 weeks significantly decreased liver steatosis (ΔATT -0.006±0.023 vs -0.016±0.021 dB/cm/MHz, p=0.046). The group of patients treated with synbiotics showed a significant decrease in the level of high-sensitive C-reactive protein (Δhs-CRP 0 vs -0.7 mg/L, p≤0.001). Synbiotics enriched the microbiome of patients in the intervention group with the genera Lactobacillus, Bifidobacterium, Faecalibacterium, and Streptococcus, by 81%, 55%, 51%, and 40%, respectively, with a reduction of Ruminococcus and Enterobacterium by 35% and 40%. Synbiotic treatment significantly shortened the gut transition time (ΔGTT -5h vs. -10h, p=0.031). Conclusion: Synbiotics could be an effective and safe option that could have place in MASLD treatment.