These findings imply that TSS supplementation, in combination with aerobic exercise, holds promise in addressing oxidative stress, insulin resistance, dyslipidemia, and steatosis, key pathological features of NAFLD, by regulating AMPK/SIRT1/PGC-1α signaling and downstream metabolic and antioxidant pathways. Here, PRKAA1 is linked to metabolic dysfunction-associated steatotic liver disease.