Impact of probiotics and prebiotics on glucose/lipid metabolism in metabolic dysfunction-associated steatotic liver disease: mechanisms and implications

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern, intricately linked to metabolic disorders such as obesity, dyslipidemia, and insulin resistance. As conventional pharmacological treatments often show limited efficacy, there is increasing interest in functional foods, particularly probiotics and prebiotics, as potential therapeutic strategies for managing MASLD and related metabolic disturbances. This perspective article explores the mechanisms by which probiotics and prebiotics influence glucose and lipid metabolism in MASLD. And by synthesizing data from recent high-level meta-analyses and umbrella reviews (up to 2025),provides a quantitative mini-meta-summary of current clinical evidence. Probiotics modulate the gut-liver axis, reducing inflammation and improving lipid metabolism, while prebiotics, such as dietary fibers and bioactive compounds, promote beneficial gut microbiota changes that support metabolic regulation. Both preclinical and clinical studies provide evidence of their beneficial effects on liver function, insulin sensitivity, and lipid profiles. This article bridges the gap between mechanistic insights and clinical outcomes, emphasizing the transition from generic supplementation to evidence-based, duration-targeted therapeutic strategies. Future research should focus on identifying optimal probiotic strains and prebiotic compounds, investigating their synergistic effects, and conducting large-scale clinical trials to solidify their therapeutic potential.