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Updated: Jan 31, 2026
Mouse Model of Metabolic Dysfunction-Associated Steatotic Liver Disease with Fibrosis
Published on: July 18, 2025
Multi-strain synbiotic and lifestyle modifications on patients with metabolic dysfunction-associated steatotic liver
Masoud Faghieh Dinavari1, Samaneh Abbasian1, Amirreza Jabbaripour Sarmadian1
1Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Background:
MASLD is the most common chronic liver disease and the leading cause of liver-related morbidity and mortality globally. While probiotic supplementations show promise as adjunctive therapy, existing trials are limited by the quality of evidence, small sample sizes, and methodological inconsistencies, highlighting the need for well-designed studies, particularly on multi-strain synbiotics. Therefore, we conducted this trial to evaluate the effects of multi-strain synbiotic combined with lifestyle modifications, including an individualized diet and physical activity program, on patients with MASLD.
Methods:
In this randomized, double-blinded, placebo-controlled trial, 80 MASLD patients were enrolled and underwent lifestyle modifications. Participants were randomized in a 1:1 ratio to receive either synbiotic capsules (500 mg each, 109 CFU per capsule) containing two strains of Bifidobacteria, two strains of Lacticaseibacillus, two strains of Lactobacillus, and one strain of Streptococcus, as well as Fructooligosaccharides as prebiotic, or placebo (one capsule every 12 h) for 12 weeks. All patients were evaluated both at the beginning and the end of the trial in terms of anthropometric parameters (weight, BMI, and WC), hematological parameters (Hb and Plt), coagulation status (PT and INR), lipid profile (TG, TC, HDL-C, and LDL-C), FBS, liver function (ALT and AST), and liver inflammatory biomarkers (TNF-α and IL-6).
Results:
No significant changes were observed in anthropometric measures either within or between groups during the study period. Moreover, analysis of venous blood samples at the end of the trial showed significant improvements in some measures of lipid profile (TC and LDL-C), FBS, liver function (ALT and AST), and liver inflammatory biomarkers (TNF-α and IL-6) in the synbiotics-receiving group compared to both the beginning of the trial and the placebo-receiving group. However, no significant changes were observed in hematological parameters (Hb and Plt), coagulation status (PT and INR), and lipid profile (TG and HDL-C) compared to the beginning of the trial and the placebo-receiving group. Supplements were tolerated well, with no complications or allergic reactions reported.
Conclusions:
Supplementation with multi-strain synbiotics, in combination with lifestyle modifications, could serve as a promising adjunctive therapy to control disease progression in patients with MASLD.
Insights
Multi-strain synbiotics combined with lifestyle changes improved lipid profiles, liver function, and inflammation in MASLD patients. This synbiotic therapy shows promise for managing metabolic-associated steatotic liver disease progression.
Area of Science:
- Gastroenterology and Hepatology
- Microbiome Research
- Metabolic Disorders
Background:
- Metabolic-associated steatotic liver disease (MASLD) is a prevalent global health issue.
- Current research on probiotic supplementation for MASLD is limited by study quality and sample size.
- There is a need for well-designed trials investigating multi-strain synbiotics for MASLD management.
Purpose of the Study:
- To evaluate the efficacy of a multi-strain synbiotic combined with lifestyle modifications in patients with MASLD.
- To assess the impact of synbiotics on anthropometric, hematological, coagulation, lipid, glycemic, liver function, and inflammatory markers.
- To determine if synbiotics can serve as an adjunctive therapy for controlling MASLD progression.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 80 MASLD patients.
- Participants received either a multi-strain synbiotic (Bifidobacteria, Lacticaseibacillus, Lactobacillus, Streptococcus, and Fructooligosaccharides) or placebo for 12 weeks, alongside lifestyle modifications.
- Comprehensive evaluations included anthropometric, hematological, coagulation, lipid profiles, FBS, liver function tests, and inflammatory biomarkers.
Main Results:
- No significant changes in anthropometric measures were observed.
- The synbiotic group showed significant improvements in lipid profiles (TC, LDL-C), fasting blood sugar (FBS), liver function (ALT, AST), and inflammatory markers (TNF-α, IL-6) compared to placebo.
- Hematological parameters, coagulation status, and other lipid markers (TG, HDL-C) did not show significant changes. Supplements were well-tolerated.
Conclusions:
- Multi-strain synbiotic supplementation, when combined with lifestyle modifications, demonstrates potential as an effective adjunctive therapy for MASLD.
- This approach may help control disease progression in individuals with metabolic-associated steatotic liver disease.
- Further research can build upon these findings to optimize synbiotic interventions for MASLD.
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