The effect of synbiotics on liver enzymes, obesity indices, blood pressure, lipid profile, and inflammation in patients with non-alcoholic fatty liver: A systematic review and meta-analysis of randomized controlled trials

Background: Patients with non-alcoholic fatty liver disease (NAFLD) benefit from using synbiotics. However, findings from existing trials remain contentious. Therefore, this meta-analysis evaluated the effects of synbiotics on liver enzymes, blood pressure, inflammation, and lipid profiles in patients with NAFLD. Methods: We searched PubMed, Embase, Cochrane, Scopus, and Web of Science for randomized controlled trials (RCTs) regarding synbiotics supplementation in patients with NAFLD. Results: The meta-analysis revealed that synbiotics supplementation significantly improved liver enzymes (AST, WMD:-9.12 IU/L; 95% CI:-13.19 to-5.05; ALT, WMD:-8.53 IU/L; 95% CI:-15.07 to-1.99; GGT, WMD:-10.42 IU/L; 95% CI:-15.19 to-5.65), lipid profile (TC, WMD:-7.74 mg/dL; 95% CI:-12.56 to-2.92), obesity indices (body weight, WMD:-1.95 kg; 95% CI:-3.69 to-0.22; WC, WMD:-1.40 cm; 95% CI:-2.71 to-0.10), systolic blood pressure (SBP, WMD:-6.00 mmHg; 95% CI:-11.52 to-0.49), and inflammatory markers (CRP, WMD:-0.69 mg/L; 95% CI:-1.17 to-0.21; TNF-alpha, WMD:-14.01 pg/mL; 95% CI:-21.81 to-6.20). Conclusion: Overall, supplementation with synbiotics positively improved liver enzymes, obesity indices, and inflammatory cytokines in patients with NAFLD.