Subjects having NAFLD with significant fibrosis showed an independent association with overall osteopenia and osteoporosis (OR = 4.10, 95% CI = 1.02–16.45) in the model 5 adjusted for age, sex, BMI, fasting plasma glucose, ALT, HDL cholesterol, and CAP, compared to those having NAFLD without significant fibrosis. The gene discussed is GPT; the disease is metabolic dysfunction-associated steatotic liver disease.