SHBG and metabolic dysfunction-associated steatotic liver disease: The hazard ratio for NAFLD in women with PCOS was 2.23 (95% CI 1.86–2.66, p < 0.001), indicating an increased rate of NAFLD in these women. Serum testosterone > 3 nmol/L and SHBG < 30 nmol/L both resulted in increased NAFLD rates. BMI, dysglycemia, and hyperandrogenism contribute to the elevated risk in these patients.