After adjusting for age, sex, ethnicity, smoking, alcohol consumption, hepatitis, and metabolic risk factors (including diabetes, hypertension, hypertriglyceridemia, elevated CRP, obesity, and increased bilirubin, ALP, AST, and ALT), MASLD remained significantly associated with all-cause mortality (adjusted HR = 1.19; P = 0.006). This evidence concerns the gene GPT and obesity due to melanocortin 4 receptor deficiency.