INS and metabolic dysfunction-associated steatotic liver disease: fT3/fT4 ratio was positively correlated with fasting blood glucose (r: 0.64, p: 0.003), insulin (r: 0.52, p: 0.02) and HOMA-IR (r: 0.58, p: 0.008) in the NAFLD group with elevated TSH levels (TSH >4) (Table 3).