Overall, we demonstrated a significant positive correlation between AGP and both NAFLD and LF in adult females, with odds ratios of 12.00 [95% CI (6.73, 21.39)] and 2.20 [95% CI (1.07, 4.50)], respectively, after adjusting for multiple covariates. This evidence concerns the gene ATP5MK and metabolic dysfunction-associated steatotic liver disease.