Probiotics and non-alcoholic fatty liver disease in children and adolescents: a systematic review

• David Avelar-Rodríguez ^[1] ; Rubén Peña-Vélez ^[4] ; Jelena Popov ^[2] ; Lee Hill ^[3] ; Paul MacDaragh Ryan ^[5]
  1. [1] Hospital for Sick Children

     Hospital for Sick Children

     Canadá

     
  2. [2] University College Cork

     University College Cork

     Irlanda

     
  3. [3] McMaster University

     McMaster University

     Canadá

     
  4. [4] Hospital General de Puebla Dr. Eduardo Vázquez Navarro. Puebla, Mexico
  5. [5] Cork University Hospital. Cork, Ireland

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• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 115, Nº. 8, 2023, págs. 418-427
• Idioma: inglés
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• Dialnet Métricas: 1 Cita
• Resumen

  • 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.