Meta-analysis (2023 [161], 41 RCTs)—Probiotic or synbiotic supplements significantly reduced liver fat (improved ultrasound-detected steatosis), lowered ALT, AST, and GGT, and even improved fibrosis markers in NAFLD. RCT examples: ~6–12-month probiotic regimens in NAFLD have shown decreased ALT/AST and improved insulin resistance (HOMA-IR) compared to a placebo. Generally well-tolerated. The gene discussed is GPT; the disease is Insulin resistance.