After adjustment for age, gender, current smoking, alcohol consumption, and physical activity, elevated circulating adipsin levels were closely related to reduced risk of NAFLD [OR (95% CI): 0.850(0.752–0.961), p = 0.010]; however, circulating adipsin was not significantly associated with risks of elevated serum ALT, AST and GGT, MetS, and significant liver fibrosis. Here, GPT is linked to metabolic syndrome.