the effect of probiotic and/or prebiotic on liver function tests in patients with nonalcoholic fatty liver disease: a double blind randomized clinical trial

background oral administration of pro- and prebiotics has recently been considered as an effective way for nonalcoholic fatty liver disease (nafld) recovery. objectives the current study aimed at evaluating the effect of supplementation with probiotics and/or prebiotics on liver function tests in patients with nafld. methods in this double blind, placebo-control clinical trial, 75 subjects with nafld were voluntarily recruited from may 2013 to march 2014, in iran. participants were randomly assigned to 1 of 4 groups using a block randomization procedure. group 1 received probiotic capsules (bifidobacterium longum (bl) and lactobacillus acidophilus (la): 2 × 107 cfu/day), group 2 received prebiotic inulin high performance (hp): 10 g/day, group 3 received probiotic and the prebiotic, and group 4 received a placebo for 3 months. the sample size was determined on the basis of a primary outcome of a change in aspartate aminotransferase (ast) level. results an intergroup comparison indicated that the ast (p = 0.006) and alanine aminotransferase (alt) (p = 0.04) levels decreased at the end of the study. aspartate aminotransferase (mean difference of group1 versus placebo with p value of 0.001, group2 versus placebo with p value of 0.045, group3 versus placebo with p value of 0.015) and alt (mean difference of group 1 versus placebo with p value of 0.009, group 2 versus placebo with p value of 0.041, and group 3 versus placebo with p value of 0.046) serum levels decreased significantly in all of the intervention groups compared to the placebo. the grade of fatty liver in group 1 (p of 0.027, and number needed to treat (nnt) = 3) and group 3 (p = 0.019 and nnt = 3) decreased compared to the placebo group with no significant changes in group 2. conclusions supplementation with probiotics and/or prebiotics improved aminotransferase enzymes, and supplementation with probiotics or pro- and prebiotics recovered the grade of fatty liver in nafld patients.