Jiawei Yu, Gaoyang Cao, Shuohui Yuan, Cong Luo, Jiafeng Yu, Ming Cai
Journal: BMJ open 2021;11(3):e041393
PMID: 33653743
Osteoporosis is a disease where bone density is decreased and is often seen in postmenopausal women. Current prescribed treatments are costly and can often have serious side effects and as a result natural treatments are often requested. Probiotics have been shown in previous studies to be of benefit to bones, however no large review of all the available studies has been performed. This systematic review and meta-analysis of current randomised control trials (RCT’s) aimed to summarise the effect of probiotics on bone density in postmenopausal women. The results showed that only five RCT’s were available on the effect of probiotics on bone density of which there were 497 postmenopausal women. Bone density at the base of the spine was increased in women taking probiotics, however there was no difference seen in bone density of the hip. Bone markers for bone degradation were decreased, however other markers associated with bone density changes were unaffected. It was concluded that probiotics may increase bone density at the base of the spine, however more high-quality studies are needed. This study could be used by healthcare professionals to understand how probiotics may be of benefit to postmenopausal women, however definitive recommendations based on this study may need to be made with caution.
OBJECTIVE
Osteoporosis 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.
DESIGN
Systematic review and meta-analysis.
METHODS
We 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.
RESULTS
Five 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.
CONCLUSIONS
We conclude cautiously that supplementation with probiotics could increase lumbar BMD. More RCTs are recommended to validate or update these results.
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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