The impact of probiotics on gut microbiota and non-alcoholic fatty liver disease (NAFLD) progression based on controlled attenuated parameter (CAP) elastography: Randomized controlled trial

Abstract

Background: The gut–liver axis has many implications in non-alcoholic fatty liver disease onset as the major contributor of intestinal dysbiosis. Gut microbiota have an important role in intestinal barrier function and reversal of leaky gut. Probiotics may restore intestinal barrier integrity and contribute to hepatic functions recovery and alleviating inflammatory and fibrogenic processes. We aimed to evaluate the impact of probiotics on gut microbiota and non-alcoholic fatty liver disease progression. Results: Sixty non-alcoholic fatty liver disease patients (30 non-alcoholic fatty liver and 30 non-alcoholic steatohepatitis patients) were included in this open label randomized controlled study. Half of the patients of each group were randomized to receive probiotics in addition to classic management. The patients were followed-up for 6 months. The non-alcoholic fatty liver disease patients in the probiotic group experienced significant improvement in their Alanine aminotransferase, triglycerides, liver steatosis, and fibrosis stages, fecal pathological bacterial growth and Lactobacillus acidophilus abundance (P= 0.05, 0.029, 0.012, 0.013, 0.034, <0.001 and 0.005 respectively). Waist circumference and low density lipoprotein improvements were more pronounced in non-alcoholic fatty liver patients. Conclusion: Adding probiotic therapy to classical management of non-alcoholic fatty liver disease may help in improving intestinal dysbiosis, liver steatosis and fibrosis.