Some studies have confirmed that estrogen has a certain protective effect on the occurrence of NAFLD (26, 27).Testosterone, as a primary androgen, serves as a crucial regulator for reproductive organs and other tissues and is associated with cardiovascular diseases (28), diabetes (29), and metabolic syndrome (30).SHBG is a homodimeric glycoprotein produced by the liver. This evidence concerns the gene SHBG and metabolic dysfunction-associated steatotic liver disease.