BMC Gastroenterol. 2026 Jul 10. doi: 10.1186/s12876-026-05037-4. Online ahead of print.
ABSTRACT
BACKGROUND: Metabolic syndrome (MetS) is a global health challenge, with impaired lipid metabolism as a key feature. While fecal microbiota transplantation (FMT) shows promise as a MetS therapy, existing meta-analyses have reported conflicting results and focused mainly on glycemic parameters, leaving its impact on lipid metabolism largely unexplored. This meta-analysis systematically assessed the influence of allogenic FMT on lipid parameters in patients with MetS, unraveling its potential as an innovative therapeutic modality for this population.
METHODS: A meta-analysis was performed to explore the impact of allogenic FMT on lipid parameters (triglycerides, total cholesterol [TCHO], high-density lipoprotein cholesterol [HDL-C] and low-density lipoprotein cholesterol [LDL-C]) in patients with MetS. Terms regarding FMT and MetS were searched in PubMed/Medline, EMBASE, Web of Science, the Cochrane Library, and Scopus from the inception of the databases until 31 August 2023.
RESULTS: Nine randomized controlled trials (RCTs) were included and subgroup analyses according to follow-up durations were performed. This study was registered in PROSPERO (ID CRD42023389890). A total of 248 patients were included. Patients undergoing allogenic FMT manifested significantly lower TG level compared with control group (receiving placebo or autologous FMT, pooled MD -0.15 [95% CI: -0.29, -0.01]), as well as higher HDL-C level (MD 0.07 [95% CI: 0.02, 0.12]). Subgroup analysis confirmed that these effects were significant at 4 to 6 weeks post-FMT (TG: MD -0.16, 95% CI: -0.32, -0.01; HDL-C: MD 0.08, 95% CI: 0.02, 0.15). No significant difference was observed between allogenic FMT and control group concerning TCHO and LDL-C levels regardless of lengths of follow-up. In subgroup analysis, the results regarding TG and HDL-C remained consistent in the subgroup with 4 to 6 weeks of follow-up.
CONCLUSIONS: An overall reduction in TG level and elevation in HDL-C level was observed in patients with MetS receiving allogenic FMT. A potential optimal timeframe for FMT efficacy manifestation might be 4 to 6 weeks after first administration.
TRIAL REGISTRATION: This study is registered in PROSPERO and is available at https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023389890.
PMID:42432504 | DOI:10.1186/s12876-026-05037-4