Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with insulin resistance and metabolic disturbances. Sex hormone-binding globulin (SHBG) is closely linked to metabolic regulation and has been shown to differ between individuals with and without MASLD. Objective: This study aimed to investigate the associations between SHBG and MASLD and their relationships with insulin resistance, body mass index (BMI), age, and sex in a combined male–female cohort. Patients and Methods: We studied 98 men and 54 women with MASLD and 74 men and 55 women without MASLD (aged 25–64 years). Participants underwent abdominal ultrasonography and fasting blood sampling, including measurements of glucose, liver enzymes, lipids, insulin, SHBG, estradiol, and testosterone. Results: SHBG levels were lower in individuals with MASLD than in controls, with a more pronounced reduction in women. MASLD status was associated with an approximately 10 nmol/L lower SHBG concentration (p < 0.0001; gender × MASLD interaction p = 0.0462). Higher estradiol levels were associated with higher SHBG concentrations (p = 0.0009), although this association differed by sex (gender × log-estradiol interaction p = 0.0147). Older age and higher total cholesterol levels were associated with higher SHBG levels, whereas higher triglyceride levels were associated with lower SHBG levels. Conclusions: SHBG showed significant associations with MASLD and with key metabolic and hormonal factors, including BMI, age, and sex. Inclusion of both men and women extends prior male-only research and provides a broader characterisation of sex-specific associations in MASLD.

Background/Objectives: Long-term thyroid function in war veterans remains insufficiently characterized. This study examined the prevalence of thyroid dysfunction in Croatian Homeland War veterans compared to controls. Methods: Cross-sectional study comparing 337 male veterans (mean age 62.4 years) with 335 age-comparable male controls (mean age 61.7 years). Thyroid function was assessed via TSH and FT4. The main outcome of interest was the prevalence of subclinical hypothyroidism (TSH over 4.0 mIU/L with normal FT4). Results: Subclinical hypothyroidism was more prevalent in veterans (12.5%, 42/335) than controls (5.2%, 16/305; OR = 2.59, 95% CI: 1.42–4.71, $p$ = 0.001). After adjustment for age and BMI, the association remained significant (adjusted OR = 2.25, 95% CI: 1.19–4.23, $p$ = 0.012). Mean TSH was modestly higher in veterans (2.53 ± 1.47 vs. 2.06 ± 1.10 mIU/L, p = 0.001), with both groups’ mean values within the normal reference range. Other biochemical parameters showed no significant differences. Conclusions: Veterans showed a higher prevalence of subclinical hypothyroidism compared to controls. The clinical significance of this finding requires further investigation, as mean TSH values remained within normal limits in both groups. The cross-sectional design precludes causal inference, and unmeasured confounders may contribute to the observed association.