## 3 Results  
The mean age of the study population was 60.8 \(\pm\) 7 years, with 70% of the sample being female. The prevalence of NAFLD was 53%, and general and android obesity were 34% and 73%, respectively. The mean HGS was 17.9 \(\pm\) 3 kg, 22.4 \(\pm\) 4 kg, and 36.1 \(\pm\) 7 kg, and the rHGS was 0.59 \(\pm\) 0.09, 0.80 \(\pm\) 0.08, and 1.33 \(\pm\) 0.25 in tertile I, tertile II, and tertile III, respectively (Table 1). An increase in muscle strength was associated with a decrease in the mean age and BMI (\(p<\) 0.001 for both factors; Table 1). In the rHGS tertiles, there was also a statistically significant difference in TG, HDL-C, AST, creatinine level, and the prevalence of gender, smoking habit, physical activity, hyperlipidemia, and general and android obesity (Table 1). Furthermore, the CAP score was significantly higher in the individuals in the first tertile of rHGS than those in the second and third tertiles (266 \(\pm\) 48 dB/m, 252 \(\pm\) 49 dB/m, and 249 \(\pm\) 47 dB/m, \(p\) = 0.012, respectively) (Table 1). GLM shows that the CAP score was significantly different among tertiles even after adjustment for confounding variables (\(p\) = 0.001; Table 1). The prevalence of hepatic steatosis was 64%, 51%, and 46% in the tertile I, tertile II, and tertile III of rHGS, respectively (\(p\) = 0.004) (Figure 2a). The prevalence of the diagnosis S3 grade of steatosis was 37% in the first tertile, 31% in the second tertile, and 28% in the third tertile of rHGS (\(p\) = 0.024) (Figure 2b). After adjustment for confounding variables, the statistically significant differences in the prevalence of NAFLD and of steatosis of S3 grade persisted among rHGS tertiles (\(p\) = 0.023 and \(p\) = 0.005, respectively) (Figure 2a,b). Demographic, clinical, and instrumental characteristics of the women divided into rHGS tertiles are shown in Table S1. In the female population, we found that the CAP score, prevalence of NAFLD, and hepatic steatosis S3 grade were significantly higher in the first and second tertiles of rHGS than those in the third tertile (Table S1). In women, these results remained significantly different among rHGS tertiles even after adjustment for confounding variables (Supplementary Table S1). We also investigated the prevalence of NAFLD in the population stratified by BMI. Within the normal-weight population divided into rHGS tertiles, we observed a higher prevalence of NAFLD in the first and second tertiles compared to the third (39%, 23%, and 10%, \(p\) = 0.035, respectively) (Supplementary Figure S1A). The same result is also confirmed in the overweight/obese population categorized by rHGS tertiles (77%, 63%, and 48%, \(p\) = 0.013, respectively) (Supplementary Figure S1B). Additionally, our analysis of participants with or without NAFLD revealed that those with hepatic steatosis exhibited significantly lower rHGS compared to those without NAFLD (0.86 \(\pm\) 0.3 vs. 0.96 \(\pm\) 0.4, \(p\) = 0.008, respectively). Notably, this result retained statistical significance even after adjusting for confounding variables such as age, gender, smoking habits, physical activity, hyperlipidemia, and general and android obesity (\(p\) = 0.004). After adjusted for age and gender (Model 1), the multinomial logistic regression analysis showed that adults in tertile I and tertile II have significantly higher ORs of having NAFLD (Tertile I: OR = 4.85, 95% CI = 2.30-10.20, \(p\) < 0.001; Tertile II: OR = 2.48, 95% CI = 1.26-4.87, \(p\) = 0.008, respectively) compared to those in rHGS tertile III (Table 2). In Model 2, only the subjects in the first tertile exhibited a significantly higher odds ratio (OR)