To summarise the current data on the effectiveness of probiotics in juvenile nonalcoholic fatty liver disease (NAFLD), researchers performed a comprehensive review and meta-analysis. In order to determine whether or not probiotics are effective in the management of NAFLD in children, a comprehensive literature search was conducted using major internet databases up until September 9, 2021. For continuous outcomes, investigators utilized weighted mean differences (WMD) and standard deviations (SD), and for binary outcomes, they used a Risk Ratio with 95% CI. A total of 238 children and young adults were diagnosed with NAFLD. Probiotic supplementation revealed a statistically significant difference in transaminases’ levels (ALT: WMD=–7.51 IU/L, 95% CI, –11.28 to –3.73, I2=0%, P<0.0001; AST: WMD=–6.46 IU/L, 95% CI, –9.31 to –3.61, I2=0%, P<0.00001), anthropometric characteristics, total cholesterol, triglycerides and ultrasonographic steatosis improvement. This meta-analysis suggests that probiotic supplementation, particularly supplementation of Lactobacillus acidophilus in combination with other strains of Bifidobacterium or Lactobacillus, may help enhance the levels of transaminases, lipid parameters, ultrasonographic, and anthropometric characteristics in children with NAFLD. The current state of knowledge does not permit identifying the precise strain of helpful probiotics stated above. It is recommended that future research investigate the potential impact of probiotics on liver histological improvement in pediatric NAFLD.

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