Single strain probiotics for dyslipidemia, fatty liver, and obesity: A systematic review and meta-analysis

Table 1 Characteristics of the included studies

First author	Year	Study period	Country	Study design	Participant, n	Age range (yr)	Treatment period (d)	Ref.
Simons	2006	2004-2005	Australia	Randomized, double blind, placebo-controlled	44	30-75	70	[24]
Ooi	2010	-	Malaysia	Randomized, double blind, placebo-controlled	32	18 years of age or older	84	[21]
Jones	2012	-	Canada	Randomized, double blind, placebo-controlled	127	20-75	63	[19]
Fuentes	2013	-	Spain	Randomized, double blind, placebo-controlled	60	18-65	84	[15]
Sanchez	2014	-	Canada	Randomized, double blind, placebo-controlled	93	18-55	168	[23]
Childs	2014	2008-2009	United Kingdom	Randomized, double blind, placebo-controlled, factorial, cross-over	42	25-65	21	[13]
Rajkumar	2015	-	India	Randomized, single blind, placebo-controlled	45	20-25	45	[22]
Ahn	2015	2012-2014	South Korea	Randomized, double blind, placebo-controlled	92	-	84	[12]
Higashikawa	2016	2013	Japan	Randomized, double blind, placebo-controlled	41	20-70	84	[17]
Fuentes	2016	2010	Spain	Randomized, double blind, placebo-controlled	60	18-25	84	[16]
Kim	2017	-	South Korea	Randomized, double blind, placebo-controlled	66	-	84	[20]
Costabile	2017	2015	United Kingdom	Randomized, double blind, placebo-controlled	46	18-50	84	[14]
Inoue	2018	-	Japan	Randomized, double blind, placebo-controlled	38	66-78	84	[18]

Table 2 Sensitivity analysis and subgroup analysis

Subgroup/sensitivity analysis		No. of groups	SMD (95%CI)	P-value	Heterogeneity (I2, P-value)
BMI
Intake duration	< 12 wk	6	-0.535 (-0.782, -0.289)	0.000	95.1% (0.000)
	= 12 wk	2	-0.220 (-0.920, 0.479)	0.537	98.1% (0.000)
Dose per day	Low-dosage (< 100*108 CFU)	4	0.024 (-0.351, 0.399)	0.900	94.4% (0.000)
	High-dosage (≥ 100*108 CFU)	4	-0.829 (-1.125, -0.532)	0.00	96.7% (0.000)
Combined with or without prebiotics	Probiotic alone	6	-0.481 (-0.730, -0.233)	0.000	95.4% (0.000)
	Combined with prebiotics	2	-0.638 (-1.304, 0.027)	0.060	97.9% (0.000)
Total cholesterol
Intake duration	< 12 wk	6	-0.225 (-0.443, -0.006)	0.044	86.9% (0.000)
	= 12 wk	4	-0.665 (-0.906, -0.424)	0.000	94.9% (0.000)
	> 12 wk	1	-0.200 (-0.607,0.208)	0.337
Dose per day	Low-dosage (< 100*108 CFU)	9	-0.496 (-0.664,0.328)	0.000	93.4% (0.000)
	High-dosage (≥ 100*108 CFU)	2	0.031 (-0.310, 0.371)	0.860	0.00% (0.336)
Combined with or without prebiotics	Probiotic alone	9	-0.466 (-0.630, -0.303)	0.000	92.7% (0.000)
	Combined with prebiotics	2	0.004 (-0.377, 0.386)	0.983	93.6% (0.000)
LDL
Intake duration	< 12 wk	4	-0.306 (-0.524, -0.088)	0.006	81.2% (0.000)
	= 12 wk	6	-0.871 (-1.113, -0.628)	0.000	94.1% (0.000)
	> 12 wk	1	-0.250 (-0.658, 0.159)	0.213
Dose per day	Low-dosage (< 100*108 CFU)	9	-0.558 (-0.725, -0.391)	0.000	91.9% (0.000)
	High-dosage (≥ 100*108 CFU)	2	-0.333 (-0.685, 0.020)	0.064	92.7% (0.000)
Combined with or without prebiotics	Probiotic alone	9	-0.609 (-0.774, -0.445)	0.000	92.0% (0.000)
	Combined with prebiotics	2	-0.042 (-0.415, 0.331)	0.826	84.8% (0.010)
HDL
Intake duration	< 12 wk	4	0.557 (0.329, 0.784)	0.000	94.0% (0.000)
	= 12 wk	6	0.273 (0.027, 0.520)	0.030	96.6% (0.000)
	> 12 wk	1	-0.501 (-0.914, -0.087)	0.018
Dose per day	Low-dosage (< 100*108 CFU)	9	0.445 (0.272, 0.617)	0.000	95.7% (0.000)
	High-dosage (≥ 100*108 CFU)	2	-0328 (-0.682, 0.025)	0.069	93.7% (0.000)
Combined with or without prebiotics	Probiotic alone	9	0.162 (-0.004, 0.329)	0.056	95.4% (0.000)
	Combined with prebiotics	2	1.158 (0.735, 1.581)	0.000	96.2% (0.000)
Triglycerides
Intake duration	< 12 wk	4	-0.277 (-0.493, -0.061)	0.000	0% (0.614)
	= 12 wk	4	-0.135 (-0.411, 0.140)	0.336	93.0% (0.000)
Dose per day	Low-dosage (< 100*108 CFU)	6	-0.298 (-0.489, -0.107)	0.770	97.4% (0.000)
	High-dosage (≥ 100*108 CFU)	2	0.055 (-0.314, 0.424)	0.069	0.0% (0.567)
Combined with or without prebiotics	Probiotic alone	6	-0.185 (-0.376, 0.006)	0.058	88.3% (0.000)
	Combined with prebiotics	2	-0.368 (0.740, 0.004)	0.052	39.4% (0.199)

SMD: Standard mead difference; CI: Confidence interval; CFU: Colony forming unit; BMI: Body mass index; HDL: High-density lipoprotein; LDL: Low-density lipoprotein.