The Effects of Synbiotics on the Liver Steatosis, Inflammation, and Gut Microbiome of Non-alcoholic Fatty Liver Disease Patients- Randomized trial

Published: 29 November 2023| Version 1 | DOI: 10.17632/4rkwh26jzt.1
Milos Mitrovic


Background: Non-alcoholic fatty liver disease (NAFLD) represents a spectrum of pathological conditions from simple fat accumulation to non-alcoholic steatohepatitis. The possible role of the intestinal microbiome on NAFLD development has recently been in focus. Our study aimed to examine the effects of synbiotic administration on the liver steatosis, lipid metabolism, inflammation, and stool microbiome composition. Materials and methods: A double-blind, placebo-controlled study was conducted involving 84 patients with NAFLD, defined by the following criteria - 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 6g 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 the synbiotic showed a statistically significant decrease in the level of high-sensitive C-reactive protein (hs-CRP) (Δhs-CRP 0 vs -0.7 mg/L, p≤0.001). Synbiotics significantly 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, safe, and affordable option that could be important in NAFLD treatment.