{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T08:47:03Z","timestamp":1791708423532,"version":"4.3.4"},"reference-count":48,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Elevated fibrinogen and plasminogen activator inhibitor-1 concentrations are associated with impaired fibrinolysis and increased cardiovascular and thrombotic risk. Although probiotic and synbiotic supplementation may influence inflammatory and hemostatic pathways, their effects on these biomarkers remain uncertain. This systematic review and meta-analysis of randomized controlled trials evaluated the effects of probiotic and synbiotic supplementation on plasma concentrations of fibrinogen and plasminogen activator inhibitor-1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This systematic review and meta-analysis included randomized controlled trials conducted in adults, irrespective of health status. PubMed, Scopus, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception through June 2025. Trials comparing oral probiotic or synbiotic supplementation with placebo or no intervention and reporting fibrinogen or plasminogen activator inhibitor-1 concentrations were included. Pooled estimates with 95% confidence intervals were calculated using the Hartung\u2013Knapp\u2013Sidik\u2013Jonkman random-effects model. Heterogeneity was assessed using I\n                      <jats:sup>2<\/jats:sup>\n                      , and certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation. The review was not prospectively registered; following completion of the review, it was retrospectively registered with the Open Science Framework on 5 September 2026 (Registration DOI: 10.17605\/OSF.IO\/R3Y82).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifteen randomized controlled trials involving 892 participants were included. Probiotic or synbiotic supplementation did not significantly reduce fibrinogen (mean difference\u2009=\u2009\u22120.15, 95% confidence interval: \u22120.48 to 0.18;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.34) or plasminogen activator inhibitor-1 concentrations (mean difference =\u2009\u22120.47, 95% confidence interval: \u22121.58 to 0.65;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.33). Subgroup analyses and meta-regression did not reveal significant effect modification. The certainty of the evidence was low because of inconsistency and imprecision.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We found no significant reduction in fibrinogen or plasminogen activator inhibitor-1 concentrations with probiotic or synbiotic supplementation. Given the low certainty of evidence and heterogeneity across trials, further high-quality randomized controlled trials are needed to identify whether specific formulations or patient groups are associated with improvements in these hemostatic and fibrinolytic biomarkers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261494342","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T03:33:43Z","timestamp":1791430423000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of probiotic and synbiotic supplementation on fibrinogen and plasminogen activator inhibitor-1 concentrations: A Grading of Recommendations Assessment, Development and Evaluation\u2013based systematic review and meta-analysis"],"prefix":"10.1177","volume":"54","author":[{"given":"Omolbanin","family":"Sargazi Aval","sequence":"first","affiliation":[{"name":"Zabol University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzieh","family":"Feyzpour","sequence":"additional","affiliation":[{"name":"Islamic Azad University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma","family":"Rashki","sequence":"additional","affiliation":[{"name":"Zahedan University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira Sadat","family":"Ghalishourani","sequence":"additional","affiliation":[{"name":"Islamic Azad University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosar","family":"Shahnazi","sequence":"additional","affiliation":[{"name":"Arak University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nashmil Omar","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Salahaddin University-Erbil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horieh","family":"Shojaan","sequence":"additional","affiliation":[{"name":"Islamic Azad University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Hashemi","sequence":"additional","affiliation":[{"name":"Zanjan University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed M Hussien","family":"M Raouf","sequence":"additional","affiliation":[{"name":"Koya University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masood","family":"Shekarchizadeh","sequence":"additional","affiliation":[{"name":"Isfahan University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-021-00607-3"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2023.1256427"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22052721"},{"key":"e_1_3_3_5_2","first-page":"385","article-title":"Relationship between some physiological biomarkers in obese men and the risk of metabolic syndrome","volume":"14","author":"Abbas A","year":"2022","unstructured":"Abbas A, Kata F. 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