Conclusion We present clear evidence for the benefit of probiotics and synbiotics supplementation  for liver steatosis , liver enzymes , lipid profiles and liver stiffness in patients with NAFLD
Background and Aim Extensive epidemiological evidence suggests that nonalcoholic fatty liver disease ( NAFLD ) is the primary chronic liver disease worldwide .
However , some studies have showed conflicting results on the effects of probiotics and synbiotics supplementation .
Therefore , we conducted a systematic review and meta- analysis to investigate the effectiveness of the supplementation in subjects with NAFLD .
Effect of a Probiotic and Metformin on Liver Aminotransferases in Non-alcoholic Steatohepatitis: A Double Blind Randomized Clinical Trial
Background : Non-alcoholic steatohepatitis ( NASH ) is a clinicopathological entity that is being recognized more frequently in recent years . This study aim ed to evaluate the effects of Metformin , with and without a probiotic supplement on liver aminotransferases in patients with NASH . Methods : Sixty four patients 18 - 75 years with NASH confirmed by biopsy and histological assessment were enrolled to study . Patients were r and omized to one of the following treatments for 6 months : Group I , probiotic ( Protexin two tablets per day ) plus Metformin 500 mg two tablets per day ( Met/Pro ) , or group II , Metformin 500 mg two tablets per day plus two placebo tablet ( Met/P ) . After 6 month alanine aminotransferase ( ALT ) , aspartate aminotransferase , and ultrasound grading of NASH were assessed . Results : In group I , serum alanine aminotransferase ( ALT : 133.7 ± 70 vs. 45.2 ± 32.5 ; P < 0.00 ) , and aspartate aminotransferase activity ( AST : 123.1 ± 72 vs. 44.2 ± 33.9 ; P < 0.001 ) , and ultrasound grading of NASH ( P < 0.001 ) all decreased significantly by the end of the treatment period . In group II , while serum alanine aminotransferase ( ALT ) was not significantly reduced ( 118.4 ± 67.9 vs. 112.5 ± 68.7 ; P < 0.064 ) , aspartate aminotransferase activity ( AST : 125.3 ± 71 vs. 113.4 ± 71 ; P < 0.001 ) , and ultrasound grading of NASH did fall significantly ( P < 0.01 ) . Body mass index ( BMI ) , fasting blood sugar ( FBS ) , cholesterol , and triglyceride fell significantly in both groups . Conclusions : Probiotic combination with Metformin improves liver aminotransferases better than metformin alone in patients with NASH
Conclusion We present clear evidence for the benefit of probiotics and synbiotics supplementation  for liver steatosis , liver enzymes , lipid profiles and liver stiffness in patients with NAFLD
Background and Aim Extensive epidemiological evidence suggests that nonalcoholic fatty liver disease ( NAFLD ) is the primary chronic liver disease worldwide .
However , some studies have showed conflicting results on the effects of probiotics and synbiotics supplementation .
Therefore , we conducted a systematic review and meta- analysis to investigate the effectiveness of the supplementation in subjects with NAFLD .