After adjusting for age, general obesity, abdominal obesity, diabetes duration, hypertension, glycemic control, dyslipidemia, hyperuricemia, LH, PRL, and estradiol, the negative association between the serum FSH level and NAFLD still remained significant (OR: 0.411, 95% CI: 0.260–0.651, p < .001). Here, PLOD1 is linked to metabolic dysfunction-associated steatotic liver disease.