The median levels of alpha-fetoprotein (182 ng/dL vs. 26.8 ng/dL, 70.5 ng/dL; P < 0.001) and protein induced by vitamin K absence II (PIVKAII) (654.5 mAU/mL vs. 94.5 mAU/mL, 45.5 mAU/mL; P < 0.003 were also higher in NAFLD-related HCC patients than in the other two groups. Here, AFP is linked to metabolic dysfunction-associated steatotic liver disease.