SHBG and metabolic dysfunction-associated steatotic liver disease: 36.8% of cases had HS vs 20.0% of controls (P < 0.05) whereas 22.8% of cases had abnormal serum aminotransferases vs only 3.3% of controls (P < 0.01). All participants who had MetS also had evidence of HS. Patients with HS were determined to be 3.55 times more likely to have PCOS [i.e., OR = 3.55 with (95% CI 1.02-5.35)]. Factors that correlate HS with PCOS are: PCOS diagnosis, advanced age, elevated BMI, WC, HOMA-IR, and FAI, as well as decreased HDL and SHBG levels. It was concluded that NAFLD was common in PCOS patients, likely due to increased androgens and metabolic abnormalities.