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

Abstract

Aim. Probiotics are considered to be bone metabolism regulators, and their efficacy as an adjuvant treatment option for osteoporosis is still controversial. The purpose of this study is to compare the available data from randomized controlled trials (RCT) of probiotics in the treatment of osteoporosis and osteopenia. Methods. As of June 2021, databases such as Medline, Embase, Web of Science, and Central Cochrane Library have been used for English-language literature searches and CNKI and China Biomedical Database have been used for Chinese-language literature searches. RevMan 5.3 was used for bias risk assessment, heterogeneity detection, and meta-analysis. This research has been registered in PROSPERO (CRD42020085934). Results. This systematic review and meta-analysis included 10 RCTs involving 1156. Compared with the placebo, the absolute value of lumbar spine’s BMD was not statistically significant (WMD 0.04 (−0.00, 0.09), P = 0.07 , random effect model), while the percentage of lumbar spine’s BMD was higher (SMD 1.16 (0.21, 2.12), P = 0.02 , random effect model). Compared with the control group, the percentage of total hip’s BMD was not statistically significant (SMD 0.52 (−0.69, 1.73), P = 0.40 , random effect model). The safety analysis showed that, compared with control group, the adverse events in the experimental group were not statistically significant (RR 1.02 (0.92, 1.12), P = 0.70 , fixed effect model). Conclusion. Probiotics may be safety supplements to improve the lumbar spine’s BMD of patients with osteoporosis and osteopenia. More large-sample, random-controlled, high-quality RCTs are needed to further verify the effectiveness and safety of probiotics in intervening osteoporosis or osteopenia.

Impacts of changes in intestinal flora on the metabolism of Sprague–Dawley rats

“…On the contrary, the propionic acid increased in the magnesium sulfate group, while butyric acid decreased. However, in previous studies, the fermentation of prebiotics (inulin-type fructans) increased the abundance of intestinal propionate and butyrate [ 38 , 39 ].…”

Evaluating the Role of Probiotics in the Prevention and Management of Age-Related Diseases

“…The elderly could present higher risk for lactobacillus bacteremia, small intestinal bacterial overgrowth (SIBO) and other systematic effects that could result from the accumulation of D-lactic acid after probiotic consumption [ 125 ]. On the contrary, recent metanalyses show that probiotic supplementation does not induce such adverse effects [ 126 , 127 , 128 ]. It should be noted however, that the documentation of safety profile and adverse effects of probiotic consumption is usually inadequately performed in the available studies.…”

Osteoporosis and Microbiota

“…Prebiyotikler, insanlar tarafından sindirilemeyen besinlerdir. Prebiyotikler ve probiyotikler, mikrobiyotayı etkileyebilir ve değiştirebilir (44,56). Prebiyotik gıdaların, bağırsak mikrobiyomunu zenginleştirdiği, bağırsaklardan D vitamininin ve kalsiyum, magnezyum gibi minerallerin emilimini arttırdığı, kemik kaybını azalttığı bildirilmiştir (57)(58)(59)(60)(61)(62)(63).…”