“…We appreciate Naharci et al 1 for their interest and constructive comments on our recent article 2 , which investigated associations between metabolic dysfunction-associated fatty liver disease (MAFLD) and fatty acid-binding protein 4 (FABP4) in a Japanese general population. In their recent letter to the editor, the authors claimed that physical activity level and renal function were not taken into consideration as potential confounders 1 .…”