In addition to liver biopsy and MRI, several studies have attempted to screen for NAFLD in patients with PCOS using biochemical and sex hormonal indicators such as the free androgen index (FAI), sex hormone-binding globulin (SHBG), alanine aminotransferase, and lipid accumulation product [18, 19]. Here, SHBG is linked to metabolic dysfunction-associated steatotic liver disease.