After controlling for possible confounders including sex, age, hypertension, diabetes, BMI, WC, systolic blood pressure (SBP), diastolic blood pressure (DBP), HB, AST, ALT, GGT, UA, TC, HDL, LDL, TSH, and FT4, FT3 remained significantly associated with an increased risk of MASLD (OR = 1.35, 95% CI: 1.23-1.49; P < 0.001). The gene discussed is GPT; the disease is hypertensive disorder.