Using this cohort study, we found the serum carotenoid levels14 and erythrocyte membrane n-3 PUFAs26 were inversely associated with risk of nonalcoholic fatty liver disease, while serum retinol-binding protein 4 levels8 was positively associated with risk of nonalcoholic fatty liver disease. This evidence concerns the gene RBP4 and metabolic dysfunction-associated steatotic liver disease.