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<p>Background:<i> Lactobacillus plantarum</i> (<i>L. plantarum</i>) has been studied for its potential effects on obesity-related outcomes, but evidence remains inconsistent. This meta‑analysis of randomized controlled trials (RCTs) evaluated the impact of <i>L. plantarum</i> supplementation on body composition, lipid profile, glycemic indices, inflammatory biomarkers, and liver enzymes in non‑diabetic overweight or obese adults. Methods: We systematically searched PubMed, Embase, Cochrane Library, Web of Science, Google Scholar, and ClinicalTrials.gov up to May 2026. Random‑effects models were used to pool weighted mean differences (WMD) with 95% confidence intervals (CI). Subgroup analyses examined strain type, intervention duration, and sample size. The risk of bias was assessed using the Risk of Bias 2 (ROB‑2) tool, and the certainty of evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Results: Seventeen RCTs were included.<i> L. plantarum</i> significantly reduced body weight (WMD: -1.20 kg; 95% CI -1.92 to -0.48; P &lt; 0.001; I²=47.4%) and waist circumference (WC) (WMD: -1.36 cm; 95% CI -2.27 to -0.45; P = 0.003; I²=58.5%) but not body mass index (BMI) (WMD: -0.25 kg/m²; p = 0.102; I²=82.8%). Greater improvements in body weight and WC were observed with multi-strain formulations, 12-week interventions, and sample sizes exceeding 50 participants. No significant overall effects were found for triglycerides (TG), total cholesterol (TC), low‑density lipoprotein cholesterol (LDL‑C), high‑density lipoprotein cholesterol (HDL‑C), fasting blood sugar (FBS), insulin, interleukin‑6 (IL‑6), C‑reactive protein (CRP), tumor necrosis factor‑α (TNF‑α), alanine aminotransferase (ALT), or aspartate aminotransferase (AST). However, intervention durations longer than 12 weeks modestly improved lipid profiles. For glycemic indices, multi-strain<i> L. plantarum</i> reduced FBS specifically in studies with &gt; 50 participants and a 12-week duration. Conclusions:<i> L. plantarum</i> supplementation, especially multi-strain and for at least 12 weeks, may modestly reduce body weight and WC. Evidence for benefits in lipid, glycemic, inflammatory, or liver enzyme levels is limited. Longer and larger trials are warranted.</p>

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Efficacy of Lactobacillus plantarum on Body Composition, Lipid Profile, Liver Enzymes, and Inflammatory Markers in Overweight or Obese Adults: A GRADE Systematic Review and Meta-analysis of Randomized Trials

  • 期刊论文

  • 发表日期：

    2026年7月28日

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  • Zhen Cheng,
  • Liping Du,
  • Wei Zheng,
  • Shuangqin Zheng,
  • Xiaoheng Zheng,
  • Zhi Liu,
  • Zhong Wong,
  • Xiaofang Ge

摘要

Background: Lactobacillus plantarum (L. plantarum) has been studied for its potential effects on obesity-related outcomes, but evidence remains inconsistent. This meta‑analysis of randomized controlled trials (RCTs) evaluated the impact of L. plantarum supplementation on body composition, lipid profile, glycemic indices, inflammatory biomarkers, and liver enzymes in non‑diabetic overweight or obese adults. Methods: We systematically searched PubMed, Embase, Cochrane Library, Web of Science, Google Scholar, and ClinicalTrials.gov up to May 2026. Random‑effects models were used to pool weighted mean differences (WMD) with 95% confidence intervals (CI). Subgroup analyses examined strain type, intervention duration, and sample size. The risk of bias was assessed using the Risk of Bias 2 (ROB‑2) tool, and the certainty of evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Results: Seventeen RCTs were included. L. plantarum significantly reduced body weight (WMD: -1.20 kg; 95% CI -1.92 to -0.48; P < 0.001; I²=47.4%) and waist circumference (WC) (WMD: -1.36 cm; 95% CI -2.27 to -0.45; P = 0.003; I²=58.5%) but not body mass index (BMI) (WMD: -0.25 kg/m²; p = 0.102; I²=82.8%). Greater improvements in body weight and WC were observed with multi-strain formulations, 12-week interventions, and sample sizes exceeding 50 participants. No significant overall effects were found for triglycerides (TG), total cholesterol (TC), low‑density lipoprotein cholesterol (LDL‑C), high‑density lipoprotein cholesterol (HDL‑C), fasting blood sugar (FBS), insulin, interleukin‑6 (IL‑6), C‑reactive protein (CRP), tumor necrosis factor‑α (TNF‑α), alanine aminotransferase (ALT), or aspartate aminotransferase (AST). However, intervention durations longer than 12 weeks modestly improved lipid profiles. For glycemic indices, multi-strain L. plantarum reduced FBS specifically in studies with > 50 participants and a 12-week duration. Conclusions: L. plantarum supplementation, especially multi-strain and for at least 12 weeks, may modestly reduce body weight and WC. Evidence for benefits in lipid, glycemic, inflammatory, or liver enzyme levels is limited. Longer and larger trials are warranted.