In the whole NAFLD cohort, NAS score ≥5 was independently associated with female gender (OR 2.55, 95% CI 1.51–4.31, p<0.001), high BMI (OR 1.11 95% CI 1.04–1.17, p = 0.004), HOMA (OR 1.13 95% CI 1.03–1.25, p = 0.01), and PNPLA3 GG (OR 2.15, 95% CI 1.22–3.77, p = 0.008) at multivariate logistic regression analysis (table 3). Here, PNPLA3 is linked to metabolic dysfunction-associated steatotic liver disease.