Probiotic supplements and bone health in postmenopausal women: a meta-analysis of randomised controlled trials

Abstract

ObjectiveOsteoporosis is a common disease in postmenopausal women. Several studies have analysed the associations between dietary supplementation with probiotics and bone health in postmenopausal women, but the results are still controversial. We conducted this meta-analysis to assess the effects of probiotics supplement on bone mineral density (BMD) and bone turnover markers for postmenopausal women.DesignSystematic review and meta-analysis.MethodsWe systematically searched PubMed, EMBASE and the Cochrane Library from their inception to November 2020 for randomised controlled trials (RCTs) assessing probiotic supplements and osteoporosis in postmenopausal women. Study-specific risk estimates were combined using random-effect models.ResultsFive RCTs (n=497) were included. Probiotic supplements were associated with a significantly higher BMD in the lumbar spine (standardised mean difference, SMD=0.27, 95% CI 0.09 to 0.44) than in control. There was no difference between probiotic supplements and BMD in hips (SMD=0.22, 95% CI −0.07 to 0.52). Collagen type 1 cross-linked C-telopeptide levels in the treatment groups were significantly lower than those of the placebo group (SMD=−0.34, 95% CI −0.60 to −0.09). In subgroup meta-analysis, levels of bone-specific alkaline phosphatase, osteoprotegerin, osteocalcin and tumour necrosis factor did not differ between the probiotic and placebo groups.ConclusionsWe conclude cautiously that supplementation with probiotics could increase lumbar BMD. More RCTs are recommended to validate or update these results.

Bacillus subtilis-Based Probiotic Improves Skeletal Health and Immunity in Broiler Chickens Exposed to Heat Stress

“…Secondary OP is a part of disease pathology, such as metabolic bone disorder seen in patients with inflammatory bowel diseases [ 163 , 164 ]. In both forms, one of the reasons for bone loss is an imbalance in the bone remodeling process, resulting from gut dysbiosis and related systemic inflammation [ 165 , 166 , 167 ]. In murine models, the manipulation of microbiota through the colonization of germ-free mice by the administration of antibiotics or stress hormones (such as glucocorticoids) significantly alters bone development, growth, remodeling, and strength, leading to bone loss and related bone damage [ 168 , 169 , 170 ].…”

“…Probiotics, as well as fecal microbiota transplantation, prebiotics, and nutritional interventions, display functions in reversing gut microbiota dysbiosis, restoring gut permeability, and rescuing bone loss. Probiotic administration has been considered to be a potential novel target for regulating bone homeostasis to prevent bone diseases such as OP in humans, and in various animal models with induced bone loss [ 167 , 174 , 175 , 176 ]. However, studies have shown a range of variations in the incurred benefits of probiotics; and their efficiency is species-specific due to multiple factors, including the strains of the probiotics and the host’s physical and physiological state [ 53 , 54 , 55 ].…”

The Improving Effect and Safety of Probiotic Supplements on Patients with Osteoporosis and Osteopenia: A Systematic Review and Meta-Analysis of 10 Randomized Controlled Trials

“…Compared with previous systematic review and meta-analysis [ 55 ], this study is the newest systematic review and meta-analysis strictly based on the PRISMA guidelines with preregistered plans. This study also covers a wider population (postmenopausal women, senile osteoporosis, and diabetic osteoporosis) than previous reviews.…”

“…Compared with previous systematic review and metaanalysis [55], this study is the newest systematic review and meta-analysis strictly based on the PRISMA guidelines with preregistered plans.…”

T-Cell Mediated Inflammation in Postmenopausal Osteoporosis

“…Bone loss in OVX mice can be prevented with supplementation of probiotics ( 68 ). While randomized controlled trial were conducted ( 123 ) and showed reduction in bone loss in particular with Lactobacillus reuteri ( 124 ), these results should be interpreted with caution and further studies are needed to evaluate the benefits of probiotics.…”