A similar study that administered Bifidobacterium longum with fructo-oligosaccharides to patients with MASH for 24 wk measured decreases in AST, LDL-cholesterol, TNF-α, HOMA-IR, serum endotoxin, steatosis, fibrosis, and NAS score, indicating a decrease in inflammation and fibrosis and potentially a delay in the worsening of MASH compared with control [157]. This evidence concerns the gene TNF and metabolic dysfunction-associated steatohepatitis.