Finally, we examined the robustness of the results in this study by performing a series of sensitivity analyses (conversion of the target-independent variable form, subgroup analysis, using a GAM to insert the continuity covariate as a curve into the equation, calculating E-values to investigate the possibility of unmeasured confounding, and reanalyzing the relationship between GGT/HDL-c ratio and NAFLD after excluding participants eGFR < 60 ml/min/1.73 m2, FPG > 6.1 mmol/L, TG ≥ 1.7 mmol/L, or ALT > 40 U/L) to ensure the reliability of the results. The gene discussed is GPT; the disease is metabolic dysfunction-associated steatotic liver disease.