Furthermore, increased circulating adipsin levels were significantly associated with reduced risk of NAFLD [OR (95% CI): 0.766(0.666–0.882), p < 0.001], even after adjusting for risk factors for age, gender, current smoking, alcohol consumption, physical activity, BMI, systolic BP, fasting glucose, TG, and HDL-c; nevertheless, such associations of circulating adipsin levels were not noted for risks of elevated serum ALT, AST, GGT and MetS, and significant liver fibrosis. Here, CFD is linked to metabolic dysfunction-associated steatotic liver disease.