Effect of probiotics in children with non-alcoholic fatty liver disease

Effect of Probiotics in Children with Non-Alcoholic Fatty Liver Disease Background and aim: Non-alcoholic liver disease (NAFLD) is defined as presence of fatty deposits after the exclusion of other liver diseases which cause fatty infiltration of liver and in the absense of excessive alcohol intake. Recently; gastrointestinal microbiota changes was emphasized in pathogenesis of the disease. In this study we aimed to investigate the effects of probiotic treatment in childrens with NAFLD. Method: Twenty-eight patients diagnosed NAFLD with ultrasonography (USG) whose body mass index was above 95th percentile between January 2015 and November 2015, in Pediatric Gastroenterology Department of Karadeniz Technical University Faculy of Medicine were included in this study. Age and sex matched, 30 healthy children were selected as control group. Patients receive probiotic treatment beside the diet and life style modifications and prospectively evaluated for four months. Antropometric measures, laboratory and ultrasound findings, Homeostasis Model Assesment of Insulin Resistance (HOMA-IR), serum ethanole, tumor necrosis factor alfa (TNF-α), zonulin, cytokeratin 18, total oxidant status (TOS), total anti- oxidant status (TAS) and gaita calprotectin levels were measured before and after probiotic treatment. Results: Antropometric measures, liver enzymes, lipid profile levels, insulin resistance, ethanole, TNF-α and calprotectine levels were higher in patients compared to healthy controls (p<0.05). Levels of liver enzymes, lipid profile, C reactive protein, ethanole and TNF-α were decreased and levels of TAS were increased with treatment (p<0.05). Decrease in fatty infiltration of liver was observed in 19 (67.8%) patients by USG. Laboratory parameters before the treatment was not differ between patients with and without decreased fatty infiltration. Patients with decreased fatty infiltration had significantly decreased levels of high density lipoprotein, total cholesterol, TNF-α and gaita calprotectin levels than patients whose fatty infiltration did not decreased after probiotic treatment (p<0.05). Conclusion: Probiotics were effective in treatment of NAFLD by decreasing inflammation. Key words: NAFLD, probiotics, ethanol, TNF-α