2024-06-26
Prebiotics alone are not enough to treat non-alcoholic fatty liver disease
Gastroenterology and Hepatology
Non-alcoholic fatty liver disease (NAFLD) is a common liver disease that often progresses to more serious conditions such as fibrosis and cirrhosis of the liver. There is a strong association between this disease and metabolic syndrome.
Alteration of the gut microbiota has been suggested as a factor contributing to the development and progression of NAFLD.
Here, this randomised, double-blind, placebo-controlled clinical trial explores whether administration of prebiotics can influence liver fat content and other metabolic and inflammatory parameters in patients with NAFLD.
Patients with NAFLD and metabolic syndrome were randomised to receive either 16 g/day of prebiotics (inulin-like fructans, ITFs) or placebo (maltodextrin) for 12 weeks. Measurements included liver fat content (LFC) by NMR spectroscopy (H1MRS), faecal microbiota composition, and metabolic and inflammatory parameters before and after the intervention.
The main results of this study indicated that administration of prebiotics led to a significant increase in the abundance of Bifidobacterium in the faecal samples of patients in the prebiotic group compared with the placebo group.
However, liver fat levels, liver function tests, lipid profiles, fasting blood glucose, insulin levels, HbA1c, HOMA-IR and CRP levels did not show significant changes between the groups after 12 weeks.
The results of this pilot study suggest that prebiotic treatment alone, without weight loss, is not sufficient. Although the increase in Bifidobacterium is promising, it did not translate into significant clinical improvements in terms of liver fat content or other metabolic and inflammatory markers.
This indicates that modification of the gut microbiota by prebiotics may require additional lifestyle changes, such as weight loss, to be effective in the treatment of NAFLD.
Future research should explore combinations of prebiotic treatments with weight loss strategies or other lifestyle modifications to assess their synergistic efficacy.
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