Table 2.

Impact of prebiotics, probiotics, symbiotics, and FMT on gut dysbiosis in MASLD.

Liver Condition	Gut Microbiota Treatment	Results	Reference
MASLD patients with diabetes mellitus (n = 60; 15 each arm), RCT	Prebiotics (butyrate and inulin, used alone or in combination vs. placebo)	↑ A. muciniphila upon inulin and butyrate administration; ↓ Kruppel-like factor 5 mRNA expression; ↑ microRNA-375 after butyrate and butyrate + inulin administration	[74]
MASLD patients (n = 24) with and without diabetes mellitus (n = 24) vs. HV	Probiotics	Improved insulin sensitivity	[140]
MASLD patients with diabetes mellitus (n = 70)	Probiotic with Lactobacillus casei spp.	↑ Lactobacillus and ↓ total count of fecal bacteria	[141]
MASLD (n = 26) patients with obesity and diabetes mellitus, RCT	Symbiotics	Reduced hip circumference; improved intestinal permeability with ↓ zonulin and LPS expression	[87]
MASLD (n = 63) patients with obesity, RCT	Symbiotics	↓ Firmicutes/Bacteroidetes ratio	[142]
MASLD (n = 18) patients	FMT: 9 undergoing FMT from lean male donors (allogenic group), 9 undergoing self-FMT (autologous group)	↑ Gut microbial diversity with increased abundance of butyrate-producing Roseburia Intestinalis and Eubacterium hallii ↓ Insulin resistance	[102]
MASLD (n = 38) patients	FMT: 26 undergoing FMT from lean male donors (allogenic group), 12 undergoing self-FMT (autologous group)	↑ Insulin sensitivity	[98]
MASLD (n = 30) patients	FMT: 10 undergoing allogenic FMT from lean vegan donors, 10 undergoing autologous FMT	Allogenic FMT patients with fecal gut microbial composition like those of vegan donors	[99]

Table legend: ↑—increased abundance; ↓—decreased abundance; MASLD—metabolic dysfunction-associated fatty liver disease; RCT—randomized clinical trial; LPS—lipopolysaccharide; FMT—fecal microbiota transplantation.