Impact of Probiotics on Triglyceride Level After Bariatric Surgery: A Trial Sequential Analysis

This meta-analysis and trial sequential analysis (TSA) investigated the effects of probiotic supplementation on triglyceride levels in patients after bariatric surgery. A comprehensive literature search identified seven randomized controlled trials involving 411 participants. The meta-analysis revealed a significant reduction in triglyceride levels favoring probiotic supplementation (mean difference =  - 18.46 mg/dL, 95% confidence interval [- 29.73, - 7.2], p = 0.001) with no heterogeneity (I² = 0%). The observed reduction in triglycerides (18.46 mg/dL) exceeds the reported minimal clinically important difference (MCID) threshold for triglycerides (i.e., 7.97 mg/dL), suggesting clinically meaningful improvements. TSA confirmed that sufficient evidence has been accumulated to support the effect of probiotics on triglycerides, with the cumulative Z-curve crossing the required information size of 313 participants. These findings suggest that probiotic supplementation could be a valuable adjunct therapy for managing lipid profiles in patients undergoing bariatric surgery. Future research should focus on optimizing probiotic interventions, including identifying the most effective strains, dosages, and duration of supplementation.