NAFLD patients with elevated intestinal permeability (D-lactate: 19.00 [16.48–23.23] U/L) had significantly higher levels of liver test parameters ALT, AST, GGT, TBIL, and IBIL (all P ˂ 0.05); higher levels of the liver ultrasonographic parameter, FAP (P = 0.001); higher levels of TG (P = 0.023) and an elevated HOMA-IR value (P = 0.020) among metabolic parameters; and a higher level of the intestinal parameter, DAO (P = 0.025), than those with normal intestinal permeability (D-lactate, 9.35 [6.47–12.40] U/L) (Table 2). Here, DAO is linked to metabolic dysfunction-associated steatotic liver disease.