Document Type : Original Article
Authors
1 Assistant Professor, Department of Internal Medicine, Islamic Azad University, Tabriz Branch, Tabriz, Iran
2 Assistant Professor, Department of Internal Medicine, School of Medicine, Ardabil University of Medical Science, Ardabil, Iran
3 School of Medicine, Ardabil University of Medical Science, Ardabil, Iran
4 Associate Professor, Department of Community Medicine, School of Medicine, Ardabil University of Medical Science, Ardabil, Iran
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease which is correlated with overweight, obesity, and insulin resistance. Recently, the use of probiotics has been suggested for these patients as they have considerable outcomes. The aim of the present study is to evaluate the effect of GeriLact on patients with NAFLD.
Method: In this randomized clinical trial, 61 patients with NAFLD were recruited and randomly assigned to groups receiving GeriLact, 500 mg, twice per day, or placebo (with the same dose) for sixty days. Weight, body mass index (BMI), lipid profile, fasting blood sugar (FBS), Alanine aminotransferase (ALT), Aspartate Aminotransferase (AST), and sonographic grading were evaluated before and at the end of the study.
Results: In the GeriLact group, there was a significant decrease in ALT (p=0.002) and AST (p <0.001) levels, while the placebo group showed a significant decrease only in ALT level (p=0.01). There was a significant decrease in cholesterol levels in the intervention group compared to the placebo group (p=0.01), but there were no significant changes in FBS, triglycerides, LDL, and HDL levels between the two groups. The fatty liver grade was improved by 63.6% in the intervention group and by 46.4% in the placebo group.
Conclusion: The results showed that probiotics caused significant improvement in ALT, AST, and cholesterol levels but had no effects on FBS, triglycerides, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). Overall, treatment with GeriLact was found to be effective, safe, with low cost and well-tolerated in the long term use by the patients.
Keywords
- Angulo P. Nonalcoholic fatty liver disease. N Engl J Med 2002; 346(16):1221-31.
- Brunt EM, Janney CG, Di Bisceglie AM, Neuschwander-Tetri BA, Bacon BR. Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am J Gastroenterol 1999; 94(9):2467-74.
- Adams L, Angulo P. Treatment of non-alcoholic fatty liver disease. Postgrad Med J 2006; 82(967):315-22.
- Mirzazadeh A, Sadeghirad B, Haghdoost AA, Bahreini F, Rezazadeh Kermani M. The prevalence of obesity in Iran in the recent decade; a systematic review and meta-analysis study. Iran J Public Health 2009; 38(3):1-11.
- Solga S, Alkhuraishe AR, Clark JM, Torbenson M, Greenwald A, Diehl AM, et al. Dietary composition and nonalcoholic fatty liver disease. Dig Dis Sci 2004; 49(10):1578-83.
- Iacono A, Raso GM, Canani RB, Calignano A, Meli R. Probiotics as an emerging therapeutic strategy to treat NAFLD: focus on molecular and biochemical mechanisms. J Nutr Biochem 2011; 22(8):699-711.
- Lirussi F, Mastropasqua E, Orando S, Orlando R. Probiotics for non-alcoholic fatty liver disease and/or steatohepatitis. Cochrane Database Syst Rev 2007; 1:CD005165.
- Aller R, De Luis DA, Izaola O, Conde R, Gonzalez Sagrado M, Primo D, et al. Effect of a probiotic on liver aminotransferases in nonalcoholic fatty liver disease patients: a double-blind randomized clinical trial. Eur Rev Med Pharmacol Sci 2011; 15(9):1090-5.
- Sherlock S, Dooley J. Diseases of the Liver and Biliary System. 11th ed. Oxford: Blackwell Science; 2002. p. 423.
- Day CP, James OF. Steatohepatitis: a tale of two "hits"? Gastroenterology 1998; 114(4):842-5.
- Unger RH, Orci L. Lipoapoptosis: its mechanism and its diseases. Biochim Biophys Acta 2002; 1585(2-3):202-12.
- Ritze Y, Bárdos G, Claus A, Ehrmann V, Bergheim I, Schwiertz A, et al. Lactobacillus rhamnosus GG protects against nonalcoholic fatty liver disease in mice. PLoS One 2014; 9(1):e80169.
- Abdel Monem SM. Probiotic therapy in patients with nonalcoholic steatohepatitis in Zagazig university hospitals. Euroasian J Hepatogastroenterol 2017; 7(1):101-6.
- Ferolla SM, Armiliato GN, Couto CA, Ferrari TC. Probiotics as a complementary therapeutic approach in nonalcoholic fatty liver disease. World J Hepatol2015; 7(3): 559-65.
- Lo RS, Austin AS, Freeman JG. Is there a role for probiotics in liver disease? ScientificWorldJournal 2014; 2014:874768.
- Pace F, Pace M, Quartarone G. Probiotics in digestive diseases: focus on Lactobacillus GG. Minerva Gastroenterol Dietol 2015; 61(4):273-92.
- Druart C, Alligier M, Salazar N, Neyrinck AM, Delzenne NM. Modulation of the gut microbiota by nutrients with prebiotic and probiotic properties. Adv Nutr 2014; 5(5):624S-33S.
- Ma YY, Li L, Yu CH, Shen Z, Chen LH, Li YM. Effects of probiotics on nonalcoholic fatty liver disease: a meta-analysis. World J Gastroenterol 2013; 19(40):6911-8.
- Shavakhi A, Minakari M, Firouzian H, Assali R, Hekmatdoost A, Ferns G. Effect of a probiotic and metformin on liver aminotransferases in non-alcoholic steatohepatitis: a double-blind randomized clinical trial. Int J Prev Med 2013; 4(5):531-7.
- Famouri F, Shariat Z, Hashemipour M, Keikha M, Kelishadi R. Effects of probiotics on non-alcoholic fatty liver disease in obese children and adolescents: a randomized clinical trial. J Pediatr Gastroenterol Nutr 2017; 64(3):413-7.
- Wong VW, Won GL, Chim AM, Chu WC, Yeung DK, Li KC, et al. Treatment of nonalcoholic steatohepatitis with probiotics. A proof-of-concept study. Ann Hepatol 2013; 12(2):256-62.
- Nabavi S, Rafraf M, Somi MH, Homayouni-Rad A, Asghari-Jafarabadi M. Effects of probiotic yogurt consumption on metabolic factors in individuals with nonalcoholic fatty liver disease. J Dairy Sci 2014; 97(12):7386-93.
- Rafraf M, Nabavi S, Somi M, Homayouni-Rad A, Asghari-Jafsrabadi M. Effect of probiotic yogurt on enzymes and ecogenisity of liver in individuals with non alcoholic fatty liver disease: a double-blind randomized controlled clinical trial. Journal of Advances in Medical and Biomedical Research 2015; 23(99):25-38. [In Persian].
- Manzhalii E, Virchenko O, Falalyeyeva T, Beregova T, Stremmel W. Treatment efficacy of a probiotic preparation for non-alcoholic steatohepatitis: a pilot trial. J Dig Dis 2017; 18(12):698-703.
- Buss C, Valle-Tovo C, Miozzo S, Alves de Mattos A. Probiotics and synbiotics may improve liver aminotransferases levels in non-alcoholic fatty liver disease patients. Ann Hepatol 2014; 13(5):482-8.
- Nursalim A, Madina UU, Lesmana CR. The role of probiotic in reducing hepatic inflammation among NAFLD patients: an evidence-based case report. Acta Med Indones 2016; 48(4):327-34.
- Sepideh A, Karim P, Hossein A, Leila R, Hamdollah M, Mohammad EG, et al. Effects of multistrain probiotic supplementation on glycemic and inflammatory indices in patients with nonalcoholic fatty liver disease: a double-blind randomized clinical trial. J Am Coll Nutr 2016; 35(6):500-5.
)