Journal of paediatrics and child health · 2026
Effects of Probiotic and Synbiotic Supplementation on Metabolic and Hepatic Outcomes in Children and Adolescents With Obesity, Including Those With Obesity-Related Metabolic Dysfunction-Associated Steatotic Liver Disease: A Systematic Review and Meta-Analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Pam Pedram, Safari Mohammad, Hojati Ali, Zarrin Rasoul, Faghfouri Amir Hossein
Аннотация
AIM: This systematic review and meta-analysis evaluated the effects of probiotic and synbiotic supplementation on metabolic and hepatic outcomes in children and adolescents with obesity, including those with obesity-related metabolic dysfunction-associated steatotic liver disease (MASLD).
METHODS: A comprehensive literature search of PubMed, Scopus and Web of Science was conducted up to September 2025. Randomised controlled trials (RCTs) investigating probiotic or synbiotic supplementation in paediatric populations with obesity or MASLD were included. Data were pooled using a random-effects model, and the Cochrane Risk of Bias tool and GRADE framework were used for quality assessment.
RESULTS: Thirteen RCTs (n = 848) were included. Pooled analyses demonstrated significant reductions in total cholesterol (WMD: -6.40 mg/dL, 95% CI: -8.78, -4.01), LDL-C (WMD: -2.68 mg/dL, 95% CI: -4.85, -0.50) and alanine aminotransferase (ALT) (WMD: -6.15 U/L, 95% CI: -10.14, -2.16). No significant improvements were observed in BMI z-score, waist circumference, triglycerides, HDL-C or fasting blood sugar. A significant increase in HOMA-IR was found (WMD: 0.68, 95% CI: 0.53, 0.83). Evidence certainty was high for lipid outcomes but low or very low for most other measures.
CONCLUSIONS: Despite these mixed results, substantial heterogeneity and limited evidence quality underscore the need for well-designed, strain-specific trials. Probiotic and synbiotic supplementation show promise for specific metabolic outcomes in paediatric populations, though caution is warranted regarding glucose homeostasis, and personalised approaches should be considered in clinical practice.
METHODS: A comprehensive literature search of PubMed, Scopus and Web of Science was conducted up to September 2025. Randomised controlled trials (RCTs) investigating probiotic or synbiotic supplementation in paediatric populations with obesity or MASLD were included. Data were pooled using a random-effects model, and the Cochrane Risk of Bias tool and GRADE framework were used for quality assessment.
RESULTS: Thirteen RCTs (n = 848) were included. Pooled analyses demonstrated significant reductions in total cholesterol (WMD: -6.40 mg/dL, 95% CI: -8.78, -4.01), LDL-C (WMD: -2.68 mg/dL, 95% CI: -4.85, -0.50) and alanine aminotransferase (ALT) (WMD: -6.15 U/L, 95% CI: -10.14, -2.16). No significant improvements were observed in BMI z-score, waist circumference, triglycerides, HDL-C or fasting blood sugar. A significant increase in HOMA-IR was found (WMD: 0.68, 95% CI: 0.53, 0.83). Evidence certainty was high for lipid outcomes but low or very low for most other measures.
CONCLUSIONS: Despite these mixed results, substantial heterogeneity and limited evidence quality underscore the need for well-designed, strain-specific trials. Probiotic and synbiotic supplementation show promise for specific metabolic outcomes in paediatric populations, though caution is warranted regarding glucose homeostasis, and personalised approaches should be considered in clinical practice.