The combined presence of high concentrations of the metabolites Trans-4-Hydroxy-L-Proline and 5-Aminovaleric acid, aminoacylase 1 (acy1), alcohol dehydrogenase 4 (adh4), complement component 2 (c2), carbonic anhydrase 5A (ca5a), coagulation factor VII (f7), and hyaluronidase 1 (hyal1) were indicative of a higher risk MASLD group. This evidence concerns the gene CA5A and metabolic dysfunction-associated steatotic liver disease.