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.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Type 2 diabetes mellitus (n=374). Intervention: Type 2 diabetes mellitus and metabolic risk factors (elevated BMI, hypertriglyceridemia, elevated HbA1c, hypertension) evaluated via abdominal ultrasonography vs. Adults with type 2 diabetes without NAFLD (Grade 0 normal hepatic echogenicity, n=141). Primary outcome: Frequency and sonographic grading of non-alcoholic fatty liver disease (NAFLD) using the Saverymuttu echogenicity classification (95% CI 57.2-67.2).

Q: What does this research mean for the field?

Nearly two-thirds (62.3%) of patients with type 2 diabetes have sonographically confirmed non-alcoholic fatty liver disease, with elevated BMI, triglycerides, HbA1c, and hypertension serving as independent predictors. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Zarmina Irum; Muhammad Naveed Iqbal; Fahad Qaisar

doi:10.29309/tpmj/2026.33.11.10666

November 3, 2026The Professional Medical JournalOpen Access

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.

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Key result

Type 2 diabetes carries a ~62% prevalence of NAFLD, linked to standard metabolic risk factors.

95% CI 57.2-67.2
n=374

Why the study?

This study aimed to determine the frequency and sonographic grading of non-alcoholic fatty liver disease among adults with type 2 diabetes mellitus and evaluate its associations with demographic, anthropometric, and biochemical parameters.

What is the frequency and sonographic grading of non-alcoholic fatty liver disease (NAFLD) and its independent metabolic predictors among adults with type 2 diabetes mellitus?

Study Design

Type

Cross-Sectional (n=374)

Blinding

Blinded abdominal ultrasonography (operating radiologist blinded to anthropometric, biochemical, and clinical data)

Multicenter

Yes

Structured PICO

What is the frequency and sonographic grading of non-alcoholic fatty liver disease (NAFLD) and its independent metabolic predictors among adults with type 2 diabetes mellitus?

P

Population

374 adults with type 2 diabetes mellitus (mean age 52.3 years, 54.3% female) without viral hepatitis, alcohol consumption, or BMI >40 kg/m2 evaluated cross-sectionally at two hospitals in Pakistan.

E

Exposure

Standardized blinded abdominal ultrasonography (using a 3.5–5.0 MHz convex transducer and Saverymuttu echogenicity protocol) alongside anthropometric and fasting biochemical metabolic evaluations.

O

Outcome

Frequency and sonographic severity grading (Grades 0–3 via Saverymuttu classification) of non-alcoholic fatty liver disease (NAFLD)surrogate

Nearly two-thirds (62.3%) of adults with type 2 diabetes at a Pakistani district hospital have sonographic NAFLD, predominantly moderate steatosis, driven independently by higher BMI, HbA1c, triglycerides, and hypertension.

Limitations

Cross-sectional design precludes causal inference and longitudinal tracking of steatosis progression or regression
Ultrasound lacks the capacity to reliably differentiate simple steatosis from non-alcoholic steatohepatitis or quantify fibrosis
Exclusion of individuals with BMI >40 kg/m2 may have slightly attenuated the true burden of NAFLD
Limited broad generalizability across diverse geographic and socioeconomic strata within Pakistan
Exclusion of individuals with BMI >40 kg/m² may have slightly attenuated the true burden
Single-center/regional nature of the study limits broad generalizability across diverse geographic and socioeconomic strata within Pakistan

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Answers are grounded in this paper and cite their sources.

Implication

Supports targeted NAFLD evaluation in T2DM with metabolic risks; extends regional data but remains hypothesis-generating pending prospective validation.

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.

Discussion

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Cite This Study

Irum et al. (2026) conducted a cross-sectional in Type 2 diabetes mellitus (n=374). Type 2 diabetes mellitus and metabolic risk factors (elevated BMI, hypertriglyceridemia, elevated HbA1c, hypertension) evaluated via abdominal ultrasonography vs. Adults with type 2 diabetes without NAFLD (Grade 0 normal hepatic echogenicity, n=141) was evaluated on Frequency and sonographic grading of non-alcoholic fatty liver disease (NAFLD) using the Saverymuttu echogenicity classification (95% CI 57.2-67.2).

synapsesocial.com/papers/6aed6e863dd5ffb8e184d7c7 https://doi.org/10.29309/tpmj/2026.33.11.10666

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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.

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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.

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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