Role of Lactobacillus plantarum Strains in Gut Microbiota Interventions in Obese Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Studies

Obesity is a multifactorial health condition arising from lifestyle imbalances and impaired metabolic regulation, often accompanied by gut microbial dysbiosis. Modulating the gut microbiota through probiotics has therefore gained attention as a therapeutic approach, with lactic acid bacteria such as Lactobacillus plantarum commonly used to help restore microbial balance. This study aimed to evaluate the effectiveness of Lactobacillus plantarum in improving body mass index (BMI) and lipid profiles in obese patients. A comprehensive literature search following PRISMA 2020 guidelines was conducted across PubMed, ScienceDirect, and Web of Science, and eligible studies were assessed using the Cochrane Risk of Bias 2.0 Tool. Data extraction captured key study characteristics, and a meta-analysis was performed using R Studio. The results demonstrated a significant reduction in BMI in the Lactobacillus plantarum group compared with controls (MD = –0.43; 95% CI: –0.65 to –0.21). Total cholesterol (MD = –6.76; 95% CI: –9.80 to –3.73) and LDL cholesterol (MD = –6.43; 95% CI: –8.88 to –3.98) also decreased significantly following the intervention. However, no meaningful improvements were observed for triglyceride or HDL cholesterol levels. In summary, Lactobacillus plantarum appears to be effective in reducing BMI, total cholesterol, and LDL cholesterol in obese individuals, although its influence on other lipid parameters remains limited. Therefore, selecting an appropriate probiotic strain should involve consideration of the desired metabolic outcomes, as well as formulation, dosage, and patient lifestyle.