The study found no significant association between GS and the presence of MASH or the degree of hepatic fibrosis in patients with MASLD.Future large-scale, prospective longitudinal cohort studies incorporating serial liver elastography assessments, advanced imaging modalities, and UGT1A1 genotyping are needed to better understand whether GS influences the progression of MASLD. Here, UGT1A1 is linked to metabolic dysfunction-associated steatohepatitis.