To the best of our knowledge, we are probably the first to examine the possible pathways about the relationships among SUA, insulin resistance, components of MetS and NAFLD, and we found that increased SUA levels might increase fasting insulin, blood pressure and triglyceride and decrease HDL-C levels, which may in turn induce the risk of NAFLD. The gene discussed is INS; the disease is metabolic dysfunction-associated steatotic liver disease.