The effects of dietary synbiotic supplementation on the liver enzymes, inflammatory markers and hepatic fibrosis in patients with nonalcoholic fatty liver disease: A double-blind randomized clinical trial

There is evidence suggesting a relationship between synbiotics and nonalcoholic fatty liver disease (NAFLD). Also، probable associations of synbiotics with liver and inflammatory responses are presently being investigated. The aim of our study was to determine the effects of supplementation of diet with synbiotics on the liver enzymes، inflammatory markers and hepatic fibrosis in patients with NAFLD. In this double-blind randomized clinical trial، 52 patients with NAFLD were divided in two groups، one (experimental group) receiving daily 2 synbiotic capsules (each one containing 7 probiotic strains and fructooligosaccharides) and the other (control group) receiving 2 placebo capsules، for 28 weeks. Both groups were advised to follow an energy-balanced diet and recommended to perform physical activity. Liver enzymes، inflammatory markers and hepatic fibrosis were assessed at baseline and the end of the study. In addition، at weeks 0، 14 and 28 data were collected on anthropometric measurements and physical activity. The STATA11 software was used for data analysis. At baseline no significant differences were seen in the background variables between the two groups. After 28 weeks، liver enzymes، inflammatory markers and hepatic fibrosis in the synbiotic group decreased significantly as compared with the placebo group (P<0. 001). Moreover، the treatment brought about a reduction of 2. 99 kPa in the hepatic fibrosis score (P<0. 001) in the experimental group. On the basis of the findings it can be concluded that synbiotic supplementation can bring about improvements in liver enzymes and inflammatory markers and affect favorably liver fibrosis in patients with NAFLD.