Table 1 Characteristics of the included randomized controlled trials in systematic review.

From: Effects of probiotics in patients with morbid obesity undergoing bariatric surgery: a systematic review and meta-analysis

Study(Author,Year)

Procedure

Size(I/N)

Intervetion(Dose and type)

Control

Duration

Analyzed outcomes included

Woodard, 2009

RNYGB

22/22

1 capsule/d

Each capsule contains 2.4 billion live cells of Lactobacillus.

No supplementation

6 M

%EWL, Vitamin B12.

Karbaschian, 2018

OAGB

23/23

Daily

Seven species of probiotic bacteria(Lactobacillus casei (3.5*109 CFU/g), Lactobacillus rhamnosus(7.5*108 CFU/g), Streptococcus thermophilus (1*108 CFU/g),Bifidobacterium breve(1*1010 CFU/g), Lactobacillus acidophilus (1*109 CFU/g), Bifidobacterium longum(3.5*109 CFU/g),and Lactobacillus bulgaricus (1*108 CFU/g)) and 38.5 mg fructo-oligosaccharide.

Daily

Placebo

4 M(From 4 weeks before surgery to 12 weeks after bariatric surgery)

Plasma Glucose, Insulin, HOMA-IR, QUICKI, TC, TG, HDL, LDL, BMI, Weight, WC, Vitamin B12, 25-OH Vitamin D3, Folate.

Sherf-Dagan, 2018

LSG

40/40

2 capsules/d

Each capsule contains 11 different species including 25 billion active bacteria (Lacidophilus, L. rhamnosus, L. casei, L. paracasei, Lactobacillus plantarum, Lactococcus lactis, Bifidobacterium bifidum, B. breve, B. longum, Bifidobacterium infatis, S.thermophiles).

2 capsules/d

Placebo

3 M(The change of IL-6 and TNF-a were measured after 6 months)

ALT, AST, GGT, Plasma Glucose, HbA1c, HOMA-IR, TC, TG, HDL, LDL, IL-6(6 M), TNF-α(6 M), CRP,%EWL, BMI, WC, Ferritin, Hb.

Mokhtari, 2019

OAGB

23/23

1 capsule/d

Each capsule contains seven species of probiotic bacteria(Lactobacillus casei (3.5*109 CFU/g), Lactobacillus rhamnosus(7.5*108 CFU/g), Streptococcus thermophilus (1*108 CFU/g),Bifidobacterium breve(1*1010 CFU/g), Lactobacillus acidophilus (1*109 CFU/g), Bifidobacterium longum(3.5*109 CFU/g),and Lactobacillus bulgaricus (1*108 CFU/g)) and 38.5 mg fructo-oligosaccharide.

1 capsule/d

Placebo

4 M(From 4 weeks before surgery to 12 weeks after bariatric surgery)

IL-6, TNF-α, CRP,%EWL, Dietary Energy, Dietary Protein, Dietary Cholesterol, Dietary Carbohydrate, Dietary Fat, Dietary Fiber.

Kazzi, 2021

LSG

15/20

1 capsule/d

Each capsule contains 300 mg of combined Bacillus coagulans and galactomannans constituting 4.5billion live cells.

1 capsule/d

Placebo

3 M

ALT, AST, Insulin, HbA1c, TC, TG, HDL, LDL, CRP,%EWL, BMI, Vitamin B12.

Wagner, 2021

RYGB

34/39

2 tablets/d

Each tablet contains 5 billion Lactobacillus acidophilus, Bifidobacterium lactis.

2 tablets/d Tablets(starch)

3 M

%EWL, Dietary Energy, Dietary Protein, Dietary Fat, Dietary Carbohydrates, Dietary Fibers, GSRS.

Ramos, 2021

RYGB

38/33

1 tablet/d

Each tablet contains 5 billion Lactobacillus acidophilus, Bifidobacterium lactis.

1 tablet/d

Placebo

3 M

Plasma Glucose, Serum Insulin, HbA1c, HOMA-IR, QUICKI, TC, TG, HDL, LDL,%EWL, BMI, WC, Vitamin B12,25-OH Vitamin D3, Serum Folate.

Carlos, 2022

RYGB

37/32

1 tablet/d

Each tablet contains 5 billion Lactobacillus acidophilus and Bifidobacterium lactis.

1 tablet/d

Placebo

3 M

%EWL, Weight, BES, YFBS.

Crommen, 2022

MGB

25/23

Daily

A multistrain mixture containing Lactobacillus acidophilus Bifidobacterium breve,B.longum,L. delbrueckii susp. bulgaricus, L. belveticus,L. plantarum, L. rhamnosus, L. casei, Lactococcus lactissusp.lactis, and Streptococcus thermophiles(15*109 CFU/4 g),and 3.9 g specific micronutrient mixture.

Daily

Micronutrient mixture and a placebo powder

3 M

ALT, AST, GGT, Plasma Glucose, serum insulin, HbA1c, HOMA-IR, TC, TG, LDL, HDL, IL-6, CRP,%EWL, BMI, Weight, WC, Ferritin, Hb.

Han, 2022

SG/OAGB

33/31

Twice/d

1 g Clostridium butyricum MIYAIRI, 5 billion colony-forming units.

Twice/d

Digestive enzyme

6 M

Adverse effects.

Ramos, 2022

RYGB

13/16

2 tablets/d

5 billion Lactobacillus acidophilus and 5 billion Bifidobacterium lactis.

2 tablet/d

Placebo

3 M

%EWL, BMI, Weight.

  1. I/N Intervention/control, ALT Alanine Aminotransferase, AST Aspartate Aminotransferase, GGT Glutamyl Transpeptidase, HbA1c Hemoglobin A1c, HOMA-IR Homeostatic Model Assessment for Insulin Resistance, QUICKI Quantitative Insulin Sensitivity Check Index, TC Total Cholesterol, TG Triglyceride, HDL High Dentity Lipid, LDL Low Dentity Lipid, IL-6 Interleukin-6, TNF-a Tumor Necrosis Factor-a, CRP C-reactive protein, %EWL excess weight loss, BMI body mass index, WC Waist Circumference, Hb hemoglobin, BES Binge Eating Score, YFBS The Yale Food Addiction Scale, GSRS Gastric Symptom Rating Scale.