The Role of Probiotics and Prebiotics in the Management of MASLD: A Clinical Perspective

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a global health burden linked to metabolic syndrome and gut microbiota dysbiosis. Recent studies suggest that probiotics and prebiotics may play a pivotal role in modifying gut microbiota and improving liver outcomes in MASLD. Gut microbiota modulation with probiotics and prebiotics is emerging as a promising intervention. Objective: To assess the clinical impact of probiotic-prebiotic therapy on liver function in MASLD patients. Methods: A prospective observational study was conducted on 85 patients with MASLD. Participants received a standardized combination of probiotics (Lactobacillus rhamnosus GG and Bifidobacterium longum) and prebiotics (inulin and fructooligosaccharides) for 12 weeks. Liver function tests (LFTs) including ALT, AST, and GGT were measured before and after treatment. Results: After 12 weeks, significant reductions were observed in ALT (mean reduction: 18.5 U/L, p<0.001), AST (mean reduction: 12.3 U/L, p=0.002), and GGT (mean reduction: 15.2 U/L, p=0.005). 64.7% of patients achieved normalization of at least one elevated liver enzyme. No serious adverse events were reported. Conclusion: This study provides evidence that short-term probiotic-prebiotic therapy improves liver biochemistry in MASLD patients, supporting gut microbiota modulation as an adjunctive strategy in MASLD management.