Compared with patients in the lowest tertile, female with nonHDLc/HDLc ratios in the highest tertile had a 1.66-fold increased risk of new-onset NAFLD (HR = 2.66; 95% CI, 1.13–6.24; P = 0.025), and male in this group had a 1.11-fold increased risk (HR = 2.11; 95% CI, 1.15–3.90; P = 0.016) after adjustment for age, BMI, DBP, SBP, fasting plasma glucose, TG,ALT, AST, and the development of cardiovascular disease or diabetes during follow-up. Here, GPT is linked to diabetes mellitus.