After adjusting for vital variables, including age, gender, race, education, PIR, marital status, smoking, ALT, AST, diabetes, hypertension, cardiovascular outcomes, and total cholesterol in Model 3, a significant inverse association was observed between PHDI and MASLD risk (OR = 0.987, 95% CI 0.983–0.990, p < 0.001) (Table 2). This evidence concerns the gene GPT and Hypertension.