Frequency and sonographic grading of non-alcoholic fatty liver disease (NAFLD) among Type 2 Diabetics presenting to a DHQ Hospital: A cross-sectional analytical study.

Abstract

Objective: To determine the frequency and sonographic grading of non-alcoholic fatty liver disease among adults with type 2 diabetes mellitus and evaluate associations with demographic, anthropometric and biochemical parameters. Study Design: Analytical Cross sectional. Period: June 2024 to December 2025. Setting: Department of Medicine, Bahawal Victoria Hospital Bahawalpur & Department of Radiology, District Headquarters Hospital Lodhran. Methods: Three hundred seventy-four eligible diabetic adults were enrolled via consecutive non random sampling. Exclusion criteria encompassed chronic alcohol consumption, viral hepatitis, and hepatotoxic medication use and body mass index exceeding 40 kg /m². Standardized anthropometric assessments and fasting laboratory evaluations were conducted alongside blinded abdominal ultrasonography. Hepatic steatosis severity was classified using the Saverymuttu echogenicity protocol. Multivariable logistic regression identified independent predictors. Results: The overall sonographically confirmed NAFLD frequency was 62.3% (95% CI: 57.2–67.2). Sonographic grading distribution included mild (24.1%), moderate (25.9%), and severe (12.3%) steatosis. Multivariable analysis confirmed elevated body mass index (adjusted OR: 1.28), hypertriglyceridemia (adjusted OR: 1.01), uncontrolled glycated hemoglobin (adjusted OR: 1.31), and comorbid hypertension (adjusted OR: 1.89) as significant predictors. Conclusion: Non-alcoholic fatty liver disease affects nearly two-thirds of type 2 diabetic patients in this district hospital setting, predominantly manifesting as moderate steatosis. Adiposity, dyslipidemia, glycemic instability and vascular comorbidities independently predict hepatic fat accumulation. Implementing systematic sonographic screening within routine diabetes management facilitates timely risk stratification and integrated metabolic care.