The effect of probiotics on the serum lipid levels in non-obese healthy adults with hyperlipidemia: A systematic review and meta-analysis of randomized controlled trials.

Abstract

Introduction: probiotics might have a potential effect to manage serum lipid levels as nutraceuticals. Objective: this systematic review was conducted to explore whether probiotics have an efficient result in non-obese healthy adults with hyperlipidemia. Methods: PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science were searched for randomized controlled trials (from their commencement to January 2021). This meta-analysis was performed by Review Manager 5.3 and STATA 15.1. Changes in serum lipid levels after the intervention were used to evaluate the effect of the probiotics, which were expressed as the weighted mean difference (WMD) with a 95 % confidence interval (CI). Results: a total of 16 studies, which could be regarded as 21 independent trials with 1429 participants, were included in this meta-analysis following our inclusion criteria. It could be observed that probiotics could significantly lower total cholesterol (TC) (WMD: -0.34 mmol/L, 95 % CI: -0.45 to -0.23 mmol/L; p < 0.001, I2 = 73.9 %) and low-density lipoprotein cholesterol (LDL-C) (WMD: -0.26 mmol/L, 95 % CI: -0.36 to -0.17 mmol/L; p < 0.001, I2 = 79.0 %) levels in non-obese healthy adults with hyperlipidemia, while no significant effect between the probiotic intervention and control groups was observed on high-density lipoprotein cholesterol (HDL-C) (WMD: 0.00 mmol/L, 95 % CI: -0.02 to 0.02 mmol/L; p = 0.001, I2 = 56.6 %) and triglyceride (TG) (WMD: -0.08 mmol/L, 95 % CI: -0.18 to 0.01 mmol/L; p = 0.003, I2 = 52.4 %) levels. Conclusion: this systematic review showed that probiotics may provide a promising way to reduce serum lipid levels in non-obese healthy adults with hyperlipidemia, but their specific effect still needs more clinical experiments to be proven.