Multivariate ordinal regression analysis further revealed that AST (OR = 1.149 (1.146, 1.153), P < 0.001), HDL-C (1.105 (1.068, 1.142), P < 0.001), and RC (OR = 1.114 (1.070, 1.160), P < 0.001) exacerbated NAFLD progression (Table 4), while ALT (OR = 0.939 (0.937, 0.941), P < 0.001), platelet (0.977 (0.977, 0.978), P < 0.001), and TyG (OR = 0.904 (0.869, 0.940), P < 0.001) can inhibit NAFLD progression (Table 4). Here, GPT is linked to metabolic dysfunction-associated steatotic liver disease.