Gut Microbiome-Modulating Therapeutics and Lipid Profile in Metabolic Syndrome: A Systematic Review and Meta-Analysis of Clinical Trials
Abstract
OBJECTIVES
To evaluate the effects of gut microbiome-modulating interventions (probiotics, prebiotics, synbiotics, and fecal microbiota transplantation) on lipid profile parameters in adults with metabolic syndrome (MetS).
DESIGN AND DATA SOURCES
Systematic review and random-effects meta-analysis with univariate meta-regression of controlled clinical trials indexed in PubMed, Web of Science, and Scopus through June 2025.
ELIGIBILITY CRITERIA
Controlled clinical trials in adults with MetS diagnosed according to ATP III, IDF, or WHO criteria reporting at least one lipid outcome (total cholestrol (TC), low-density lipoprotein cholestrol (LDL-C), high desntiry lipoprotein cholestrol (HDL-C), or triglycerdies (TG)). Studies without control groups, insufficient data, or populations not meeting full MetS criteria were excluded.
DATA EXTRACTION AND SYNTHESIS
Two reviewers independently screened and extracted data. Risk of bias was assessed using the Cochrane RoB 2 tool. Random-effects meta-analysis (DerSimonian-Laird) generated pooled mean differences (MDs) with 95% confidence intervals (CIs). Heterogeneity was assessed using I2 statistics. Meta-regression evaluated moderators including age, baseline BMI, intervention dose, duration, and geographic region.
RESULTS
Nineteen studies comprising 21 trial comparisons and 897 participants were included. Microbiome-modulating interventions were associated with reductions in TC (MD -8.97 mg/dL; 95% CI -12.55 to -5.38) and TG (MD -11.33…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 897 participants or records.
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