Higher liver PDFF was associated with higher levels of alanine transaminase and tyrosine (1.1 [1.1–1.1]), higher risk of Type 2 diabetes (1.2 [1.0–1.4]) and metabolic associated steatotic liver disease (MASLD) (3.8 [3.3–4.4]), and lower risk of myocardial infarction (0.81 [0.70–0.94]) and peripheral artery disease (0.87 [0.79–0.94]), which is mainly driven by the genes blocking triglycerides export from the liver. Here, GPT is linked to metabolic dysfunction-associated steatotic liver disease.