After further adjustment for gender, BMI, current smoker, physical activity, education, drinking, hypertension, diabetes, uric acid, ALT, TBIL, ALB, PLT, TG, TC, HDL-C, hs-CRP, and creatinine, the risk for NAFLD increased across the homocysteine quartiles, and the OR in the highest quartile compared with the lowest quartile was 2.08 (95% CI 1.61, 2.67). This evidence concerns the gene GPT and metabolic dysfunction-associated steatotic liver disease.