Probiotics for non-alcoholic fatty liver disease and/or steatohepatitis

  • Review
  • Intervention

Authors


Abstract

Background

Non-alcoholic fatty liver disease comprises a spectrum of diseases ranging from simple steatosis to non-alcoholic steatohepatitis, fibrosis, and cirrhosis. Probiotics have been proposed as a treatment option because of their modulating effect on the gut flora that could influence the gut-liver axis.

Objectives

To evaluate the beneficial and harmful effects of probiotics for non-alcoholic fatty liver disease and/or steatohepatitis.

Search methods

We searched The Cochrane Hepato-Biliary Group Controlled Trials Register (July 2006), the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 2, 2006), MEDLINE (1966 to May 2006), and EMBASE (1980 to May 2006). No language restrictions were applied.

Selection criteria

Randomised clinical trials evaluating probiotic treatment in any dose, duration, and route of administration versus no intervention, placebo, or other interventions in patients with non-alcoholic fatty liver disease. The diagnosis was made by history of minimal or no alcohol intake, imaging techniques showing hepatic steatosis and/or histological evidence of hepatic damage, and by exclusion of other causes of hepatic steatosis.

Data collection and analysis

We had planned to extract data in duplicate and analyse results by intention-to-treat.

Main results

No randomised clinical trials were identified. Preliminary data from two pilot non-randomised studies suggest that probiotics may be well tolerated, may improve conventional liver function tests, and may decrease markers of lipid peroxidation.

Authors' conclusions

The lack of randomised clinical trials makes it impossible to support or refute probiotics for patients with non-alcoholic fatty liver disease and non-alcoholic steatohepatitis.

摘要

背景

益生菌對於非酒精性脂肪肝疾病和/或脂肪變性肝炎之治療

非酒精性脂肪肝疾病包括從單純的脂肪變性到非酒精的脂肪變性肝炎,纖維化和肝硬化等疾病的範圍。因為益生菌對於影響腸道和肝臟之間關係的腸道菌落有的調節的作用,因此已經被提議為一種治療的選擇。

目標

評估益生菌對於非酒精性脂肪肝疾病和/或脂肪變性肝炎治療有利和有害的作用。

搜尋策略

在沒有語言的限制下,我們搜尋Cochrane肝膽群組對照試驗的登錄資料(2006年7月), 在Cochrane圖書館的CENTRAL (2006第2期), MEDLINE (1966到2006年5月),以及EMBASE(1980到2006年5月)。

選擇標準

評估在任何劑量,使用時間,以及給藥途徑的益生菌治療相較於沒有治療,安慰劑或者其他治療於非酒精性脂肪肝疾病的隨機臨床試驗。診斷的建立依據微量或者沒有酒精攝取的病史,影像結果顯示肝臟脂肪變性和/或組織學上肝損傷,以及排除其他引起肝臟脂肪變性的原因。

資料收集與分析

我們由複製本中篩選資料並且利用意圖性治療的方法來分析結果。

主要結論

沒有找到隨機臨床試驗。從兩個試驗性的非隨機研究的初步數據顯示益生菌被接受的情形不錯,也可以改善傳統的肝功能測試結果,並且可能減少脂肪過氧化反應的指標。

作者結論

缺乏隨機臨床試驗的報告以致不能支持或者反駁益生菌對於非酒精性脂肪肝疾病和非酒精性脂肪變性肝炎病患的治療。

翻譯人

本摘要由臺中榮民總醫院王建得翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

沒有證據支持或反駁益生菌對於非酒精性脂肪肝疾病和/或脂肪變性肝炎病患的治療。因為腸道菌落是可能造成肝毒性氧化傷害的潛在原因,而益生菌因其對於腸道菌落之平衡角色,已經被提議為對於非酒精性脂肪肝疾病和非酒精性脂肪變性肝炎病患的一種治療選擇。本篇文獻回顧沒有找到任何一個益生菌對於非酒精性脂肪肝疾病和非酒精性脂肪變性肝炎的隨機臨床試驗。即使有幾個試驗性研究的結果似乎大有可為,仍然須要隨機臨床試驗來評估益生菌對於非酒精性脂肪肝疾病和非酒精性脂肪變性肝炎臨床上的影響。

Plain language summary

No evidence to support or refute probiotics for patients with non-alcoholic fatty liver disease and/or steatohepatitis

Probiotics have been proposed as a treatment option for patients with non-alcoholic fatty liver disease and non-alcoholic steatohepatitis because of their balancing role on the flora of the gut that may act as a potential source of hepatotoxic oxidative injury. This review did not identify any randomised clinical trials with probiotics in non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. Even if the results from pilot studies seem promising, randomised clinical trials are necessary to asses the clinical implication of probiotics therapy in non-alcoholic fatty liver disease and non-alcoholic steatohepatitis.