Effect of Probiotic Yogurt on Enzymes and Ecogenisity of Liver in Individuals with non Alcoholic Fatty Liver Disease: A Double-Blind Randomized Controlled Clinical Trial

Background and Objective: There are evidences for the beneficial effects of probiotic products on non-alcoholic fatty liver disease (NAFLD). The aim of the current study was to investigate the effects of probiotic yogurt consumption compared to conventional yogurt on enzymes and ecogenisity of liver in patients with NAFLD. Materials and Methods: This study was conducted on ۷۲ patients with NAFLD. Subjects were randomly allocated to either the intervention or control group (n=۳۶, in each group) and consumed ۳۰۰ g of probiotic yogurt or ۳۰۰ g of conventional yogurt everyday for ۸ weeks, respectively. Dietary intakes, anthropometric parameters, liver ultrasonography, serum levels of liver enzymes were measured at the beginning and the end of the study. Statistical analysis was performed using SPSS software and chi-square test, independent sample t-tests, analysis of covariance and paired t-tests. Results: There were not any significant differences in baseline characteristics at the beginning of the study. Probiotic yogurt consumption caused ۱۳.۶% decrease in Alanine Amino Transferase (ALT) compared with the control group and reduced Aspartate Amino Transferase (AST) by ۱۳.۸۷% (P <۰.۰۲ and P <۰.۰۰۵, respectively). No significant changes were seen in AST to ALT ratio between the groups after the trial (P-value >۰.۰۵). Results of liver ultrasonography showed significant improvement in intervention group versus control group (P-value <۰.۰۲). Conclusion: Probiotic yogurt consumption lowered serum ALT and AST concentrations in our subjects and improved liver ecogenisity. Nevertheless, it might have a role in the improvment of NAFLD. ۱- Dowman JK, Tomlinson JW, Newsome PN. Pathogenesis of non-alcoholic fatty liver disease. Q J Med. ۲۰۱۰ ۱۰۳: ۷۱-۸۳. ۲- Kelishadi R, Poursafa P. Obesity and air pollution: global risk factors for pediatric non-alcoholic fatty liver disease. Hepat Mon. ۲۰۱۱ ۱۱: ۷۹۴-۸۰۲. ۳- Amarapurkar DN, Hashimoto E, Lesmana LA, Sollano JD, Chen PJ, Goh KL. How common is non-alcoholic fatty liver disease in the Asia-Pacific region and are there local differences? J Gastroenterol Hepatol. ۲۰۰۷ ۲۲: ۷۸۸-۹۳. ۴- Adibi A, Hekmatnia A, Shayganfar S. Ultrasound screening of nonalcoholic fatty liver in isfahan medical university personnel. Iranian Journal of Radiology. ۲۰۰۸ ۵: ۱-۱. ۵- Ballestri S, Lonardo A, Bonapace S, Byrne CD, Loria P, Targher G. Risk of cardiovascular, cardiac and arrhythmic complications in patients with non-alcoholic fatty liver disease. World J Gastroenterol. ۲۰۱۴ ۲۰: ۱۷۲۴-۴۵. ۶- Lam B, Younossi ZM. Review: treatment options for nonalcoholic fatty liver disease. Therapeutic Advances in Gastroenterology. ۲۰۱۰ ۳: ۱۲۱-۳۷. ۷- Eslami L, Merat S, Nasseri-Moghaddam S. Treatment of non-alcoholic fatty liver disease (NAFLD): a systematic review. Middle East J of Dig Diseases (MEJDD). ۲۰۰۹ ۱: ۸۹-۹۹. ۸- Halegoua-De Marzio D, Fenkel J. Concepts and treatment approaches in nonalcoholic fatty liver disease. Advances in Hepatology. ۲۰۱۴ ۲۰۱۴: ۷. ۹- Lata J, Jurankova J, Kopacova M, Vitek P. Probiotics in hepatology. World Journal Gasteroentrology (WJG). ۲۰۱۱ ۱۷: ۲۸۹۰-۲۸۹۶. ۱۰- Homayouni, A. Therapeutical effects of functional probiotic, prebiotic and symbiotic foods. Tabriz Unive Med Sci Iran. ۲۰۰۸. ۱۱- Goldin BR, Gorbach SL. Clinical indications for probiotics: an overview. Clin Infect Dis. ۲۰۰۸ ۴۶: S۹۶-۱۰۰. ۱۲- Lye HS, Kuan CY, Ewe JA, Fung WY, Liong MT. The improvement of hypertension by probiotics: effects on cholesterol, diabetes, renin, and phytoestrogens. Int J Molecular Sci. ۲۰۰۹ ۱۰: ۳۷۵۵-۷۵. ۱۳- Soltan Dallal MM, Yazdi MH, Hassan ZM, et al. The evaluation of probiotic effect of L.Acidophilus on the immune responses in BALB/C mice against transplanted tumor derived from breast tissue. J Zanjan Unive Med Sci. ۲۰۱۰ ۱۸: ۳۷-۴۸ ۱۴- Aller R, De Luis DA, Izaola O, et al. Effect of a probiotic on liver aminotransferases in nonalcoholic fatty liver disease patients: a double blind randomized clinical trial. Eur Rev Med Pharmacol Sci. ۲۰۱۱ ۱۵: ۱۰۹۰-۵. ۱۵- Shavakhi A, Minakari M, Firouzian H, Assali R, Hekmatdoost A, Ferns G. Effect of a probiotic and metformin on liver aminotransferases in non-alcoholic steatohepatitis: a double blind randomized clinical trial. Int J Prev Med. ۲۰۱۳ ۴: ۵۳۱-۵۳۷. ۱۶- Ranadheera R, Baines SK, Adams MC. Importance of food in probiotic efficacy. Food Research International. ۲۰۱۰ ۴۳: ۱-۷. ۱۷- De Vrese M, Schrezenmeir J. Probiotics, prebiotics, and synbiotics. Adv Biochem Eng Biotechnol. ۲۰۰۸ ۱۱۱: ۱-۶۶. ۱۸- Liu JE, Zhang Y, Zhang J, Dong PL, Chen M, Duan ZP. Probiotic yogurt effects on intestinal flora of patients with chronic liver disease. Nurs Res. ۲۰۱۰ ۵۹: ۴۲۶-۳۲. ۱۹- Ejtahed HS, Mohtadi-Nia J, Homayouni-Rad A, Niafar M, Asghari-Jafarabadi M, Mofid V. Probiotic yogurt improves antioxidant status in type ۲ diabetic patients. Nutrition. ۲۰۱۲ ۲۸: ۵۳۹-۴۳. ۲۰- Zar JH. Biostatistical analysis. ۵th ed. New York: Pearson Press ۱۹۹۸. ۲۱- Malaguarnera M, Vacante M, Antic T, et al. Bifidobacterium longum with fructo-oligosaccharides in patients with non alcoholic steatohepatitis. Dig Dis Sci. ۲۰۱۲ ۵۷: ۵۴۵-۵۳. ۲۲- Loguercio C, De Simone T, Federico A, et al. Gut-liver axis: a new point of attack to treat chronic liver damage & quest. Am J Gastroenterol. ۲۰۰۲ ۹۷: ۲۱۴۴-۶. ۲۳- Eslamparast T, Poustchi H, Zamani F, Sharafkhah M, Malekzadeh R, Hekmatdoost A. 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. Iranian Journal of Nutrition Sciences & Food Technology. ۲۰۱۳ ۸: ۱-۸. ۲۴- Vajro P, Mandato C, Licenziati MR, et al. Effects of Lactobacillus rhamnosus strain GG in pediatric obesity-related liver disease. J Pediatr Gastroenterol Nutr. ۲۰۱۱ ۵۲: ۷۴۰-۳. ۲۵- Bhathena J, Martoni C, Kulamarva A, et al. Oral probiotic microcapsule formulation ameliorates non-alcoholic fatty liver disease in bio F۱B golden Syrian hamsters. PLoS One. ۲۰۱۳ ۸: e۵۸۳۹۴. ۲۶- Li Z, Yang S, Lin H, et al. Probiotics and antibodies to TNF inhibit inflammatory activity and improve nonalcoholic fatty liver disease. Hepatology. ۲۰۰۳ ۳۷: ۳۴۳-۵۰. ۲۷- Karahan N, Isler M, Koyu A, et al. Effects of probiotics on methionine choline deficient diet-induced steatohepatitis in rats. Turk J Gastroenterol. ۲۰۱۲ ۲۳: ۱۱۰-۲۱. ۲۸- Esposito E, Iacono A, Bianco G, et al. Probiotics reduce the inflammatory response induced by a high-fat diet in the liver of young rats. J Nutr. ۲۰۰۹ ۱۳۹: ۹۰۵-۱۱. ۲۹- Paik HD, Park JS, Park E. Effects of Bacillus polyfermenticus SCD on lipid and antioxidant metabolisms in rats fed a high-fat and high-cholesterol diet. Biol Pharm Bull. ۲۰۰۵ ۲۸: ۱۲۷۰-۴. ۳۰- Kelishadi R, Farajian S, Mirlohi M. Probiotics as a novel treatment for non-alcoholic fatty liver disease a systematic review on the current evidences. Hepat Mon. ۲۰۱۳ ۱۳: e۷۲۳۳. ۳۱- Ooi LG, Liong MT. Cholesterol-lowering effects of probiotics and prebiotics: A review of in vivo and in vitro findings. Int J Mol Sci. ۲۰۱۰ ۱۱: ۲۴۹۹-۲۵۲۲. ۳۲- Liu JE, Zhang Y, Zhang J, Dong PL, Chen M, Duan ZP. Probiotic yogurt effects on intestinal flora of patients with chronic liver disease. Nurs Res. ۲۰۱۰ ۵۹: ۴۲۶-۳۲. ۳۳- Kimoto H, Ohmomo S, Okamoto T. Cholesterol removal from media by lactococci. J. Dairy Sci. ۲۰۰۲ ۸۵: ۳۱۸۲-۸۸. ۳۴- Zhuang G, Liu XM, Zhang QX, et al. Mechanisms of the cholesterol-lowering effects of probiotics. Clin Lipidology. ۲۰۱۲ ۷: ۵۰۱-۷. ۳۵- Jones ML, Chen H, Ouyang W, Metz T, Prakash S. Microencapsulated genetically engineered Lactobacillus plantarum ۸۰ (pCBH۱) for bile acid deconjugation and its implication in lowering cholesterol. J Biomed Biotechnol. ۲۰۰۴ ۱: ۶۱-۹.

Keywords:

Keywords: Non-alcoholic fatty liver disease , Probiotic , Yogurt , Liver enzymes , Ultrasonography