Investigation of the Efficacy of a Probiotic Mixture in Moderate Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Mechanistic Trial

Inclusion Criteria: * Patients aged from 18 to 75 years old * BMI 25 - 42kg/m2 * Diagnosed with MASLD and CAP value \> 268 dB/m evaluated by FibroScan® * High ALT levels (\>30 U/L in males and \>19 U/L in females) * Having at least three of the following features compatible with metabolic syndrome: i. Waist circumference ≥ 102 cm in males and ≥ 88 cm in females. ii. Fasting serum glucose (≥ 5.6 mmol/L or 100 mg/dl). iii. Glycated haemoglobin (HbA1c ≥ 5.7%/ 39 mmol/L). iv. Diagnosed or treated for type 2 diabetes. v. High blood pressure (≥ 130/85 mmHg). vi. High plasma triglycerides (≥ 1.70 mmol/L or 150 mg/dl). vii. Lower plasma of High-Density Lipoprotein (HDL cholesterol) (≤ 1.0 mmol/L or 40 mg/dl for males and ≤ 1.3 mmol/L or 50 mg/dl for females). * Stable weight in the last 3 months (less than ± 4% weight variation). * Stable medication or intake of food supplements for a medical condition that can affect study outcomes according to the Investigator's judgement in the last three months prior to study entry (bile salt sequestrants are not permitted). * Not planning to change their dietary and lifestyle habits during the study. * Willing and able to provide informed consent and comply with study procedures. Exclusion Criteria: * Fibrosis scores equal or higher than F2 (≥ 8.0 kPa). * History of acute or chronic hepatitis A, B or C, autoimmune hepatitis, drug-induced liver diseases, severe liver diseases. * Prior or pending liver transplantation. Patients with at leas…