Impact of fecal microbiota transplantation on lipid parameters in patients with metabolic syndrome: a meta-analysis.

BACKGROUND

Metabolic syndrome (MetS) is a global health challenge, with impaired lipid metabolism as a key feature. While fecal microbiota transplantation (FMT) shows promise as a MetS therapy, existing meta-analyses have reported conflicting results and focused mainly on glycemic parameters, leaving its impact on lipid metabolism largely unexplored. This meta-analysis systematically assessed the influence of allogenic FMT on lipid parameters in patients with MetS, unraveling its potential as an innovative therapeutic modality for this population.

METHODS

A meta-analysis was performed to explore the impact of allogenic FMT on lipid parameters (triglycerides, total cholesterol [TCHO], high-density lipoprotein cholesterol [HDL-C] and low-density lipoprotein cholesterol [LDL-C]) in patients with MetS. Terms regarding FMT and MetS were searched in PubMed/Medline, EMBASE, Web of Science, the Cochrane Library, and Scopus from the inception of the databases until 31 August 2023.

RESULTS

Nine randomized controlled trials (RCTs) were included and subgroup analyses according to follow-up durations were performed. This study was registered in PROSPERO (ID CRD42023389890). A total of 248 patients were included. Patients undergoing allogenic FMT manifested significantly lower TG level compared with control group (receiving placebo or autologous FMT, pooled MD -0.15 [95% CI: -0.29, -0.01]), as well as higher HDL-C level (MD 0.07 [95% CI: 0.02, 0.12]). Subgroup analysis confirmed that these effects were significant at 4 to 6 weeks post-FMT (TG: MD -0.16, 95% CI: -0.32, -0.01; HDL-C: MD 0.08, 95% CI: 0.02, 0.15). No significant difference was observed between allogenic FMT and control group concerning TCHO and LDL-C levels regardless of lengths of follow-up. In subgroup analysis, the results regarding TG and HDL-C remained consistent in the subgroup with 4 to 6 weeks of follow-up.

CONCLUSIONS

An overall reduction in TG level and elevation in HDL-C level was observed in patients with MetS receiving allogenic FMT. A potential optimal timeframe for FMT efficacy manifestation might be 4 to 6 weeks after first administration.

TRIAL REGISTRATION: This study is registered in PROSPERO and is available at https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023389890.