In this large prospective population-based study, we found that gallstone disease and cholecystectomy were significantly associated with an increased risk of PLC despite being adjusted for suspected confounders including age, gender, FBG, TC, TG, BMI, ALT, NAFLD, MetS, cirrhosis, HBV infection, alcoholic liver disease, smoking status, drinking status, and physical activity. The gene discussed is GPT; the disease is metabolic dysfunction-associated steatotic liver disease.