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). This evidence concerns the gene PRL and metabolic dysfunction-associated steatotic liver disease.