RASi ever-use in these cases was associated with reduced risk of both NAFLD development (BMI ≥ 25 kg/m2: OR 0.708, 95% CI 0.535–0.937, FPG of < 100 mg/mL: OR 0.774, 95% CI 0.606–0.987) and progression (BMI ≥ 25 kg/m2: aOR 0.668, 95% CI 0.568–0.784, FPG of < 100 mg/mL: aOR 0.732, 95% CI 0.582–0.921). This evidence concerns the gene MMP19 and metabolic dysfunction-associated steatotic liver disease.