After adjusting for potential confounders, including demographic factors (age, BMI, WC), chronic inflammation and metabolic markers (hs-CRP, UA, TG, HDL-c, LDL-c, HOMA-IR), and sex hormones (LH, FSH, E2, and FAI), a significant and independent positive association was identified between RANKL and NAFLD. Here, TNFSF11 is linked to metabolic dysfunction-associated steatotic liver disease.