Though a meta-analysis of associations between testosterone and SHBG and NAFLD which extracted data from 16 observational studies claimed that SHBG was lower in subjects with NAFLD compared to those without NAFLD [23], a significant heterogeneity was observed in the study (I2 = 99% in men, I2 = 97% in women, both p for heterogeneity < 0.01), which reduced the credibility of the conclusion. Here, SHBG is linked to metabolic dysfunction-associated steatotic liver disease.