Probiotics in the treatment of metabolic-associated fatty liver disease in adult patients: A systematic review and meta-analysis

Aim: This meta-analysis of randomized controlled trials (RCTs) was performed to evaluate the effectiveness of probiotics in treating metabolic-associated fatty liver disease (MAFLD) in adult patients, focusing primarily on liver function, glucose levels, lipid metabolism, and inflammation.Method: RCTs completed on or before November 30, 2024 were acquired from PubMed, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials databases.A meta-analysis of the therapeutic efficacy of probiotics on liver function, glucose and lipid metabolism, and inflammatory biomarkers was performed via RevMan 5.4 software.Two reviewers independently extracted studies and patient characteristics and evaluated the quality of the studies utilizing the Cochrane risk-of-bias tool.A meta-analysis was conducted using RevMan 5.4 software.Results: A total of 18 RCTs involving 962 adult patients were included.According to the results of the meta-analysis, probiotic therapy may lower the levels of alanine aminotransferase [mean difference (MD): -9.09(-10.15,-8.03), p