Meta-analysis of the Effects of Probiotics on Alcoholic Liver Disease

Abstract Background Although probiotics are considered a possible treatment for alcoholic liver disease (ALD), their effectiveness in enhancing liver function in patients with ALD is still unclear. Objective In this investigation we sought to determine the influence of probiotics on liver function markers in patients with ALD. with a focus on the efficacy of alanine aminotransferase (ALT). We also examined aspartate aminotransferase (AST), total bilirubin (TB), albumin (ALB), and gamma-glutamyl transferase (GGT). Methods Through systematic searches of medical databases, including Web of Science, PubMed, Embase, Cochrane Library, Ovid, and Wan Fang, we identified 15 randomized controlled trials involving patients with alcoholic fatty liver, alcoholic hepatitis, and alcoholic cirrhosis. Results Probiotic therapy significantly reduced levels of ALT (standard mean difference [SMD], −0.50; 95% CI, −0.86 to −0.14; P = .007) and AST (SMD,  −0.26; 95% CI, −0.52 to 0.00; P = .05). No significant effects were observed on TB (SMD,  −0.90; 95% CI, −1.06 to 0.13; P = .12), ALB (SMD, 0.16; 95% CI, −0.06 to 0.37; P = .15), or GGT (SMD, 0.14; 95% CI, −0.11 to 0.40; P = .26) levels. Regional disparities were noted, with Asian patients showing a significant reduction in ALT levels. Patients undergoing treatments lasting 8 weeks or more also showed significant reductions in ALT levels. Furthermore, in this review we identified a more pronounced effect on ALT level reduction in subgroups with a higher proportion of male participants. Conclusion According to this meta-analysis, administration of probiotics could assist in managing ALT levels in ALD patients, offering a novel approach to ALD treatment. Systematic Review Registration PROSPERO registration No. CRD42024619024.