We also studied 2 independent cohorts drawn from the same primary care database who had serum testosterone (n = 71,000) or sex hormone-binding globulin (SHBG, n = 49,000) measured and found that women with biochemical evidence of androgen excess (high testosterone, low SHBG) had an increased rate of NAFLD. Here, SHBG is linked to metabolic dysfunction-associated steatotic liver disease.