Moreover, butyrate-producing probiotic reduces hepatic lipid accumulation and inflammatory responses and improves hepatic insulin resistance via activating AMP-activated protein kinase (AMPK), AKT, and the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) in rats with NAFLD (71). This evidence concerns the gene NFE2L2 and metabolic dysfunction-associated steatotic liver disease.