Among individuals with a high NAFLD liver fat score (> − 0.640), serum fetuin-A levels were 613.5 ± 181.0 μg/ml in individuals without DPN and 611.3 ± 182.7 μg/ml in those with DPN (p = 0.956). The gene discussed is AHSG; the disease is metabolic dysfunction-associated steatotic liver disease.