ASSESSMENT OF THE PREDICTIVE ROLE OF NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) GRADES IN THE DIAGNOSIS OF DIABETES MELLITUS USING ULTRASONOGRAPHY

Background: Non-alcoholic fatty liver disease (NAFLD) is a common hepatic condition marked by excessive fat accumulation in hepatocytes, frequently seen in individuals with metabolic disorders. It is strongly associated with insulin resistance and type 2 diabetes mellitus (T2DM), both of which are increasing globally. Ultrasonography (USG) has emerged as a non-invasive, cost-effective, and sensitive tool for identifying and grading fatty liver disease, helping predict metabolic risk. Understanding the relationship between NAFLD severity and diabetes is critical for timely clinical intervention. Objective: To investigate the correlation between ultrasonographically graded NAFLD and the presence of diabetes mellitus. Methods: This cross-sectional study was conducted over a 7-month period from September 2020 to April 2021 at the Radiology Departments of Aga Khan Health Services and District Headquarters Hospital Gilgit. A total of 120 patients aged above 35 years, of both sexes, presenting with fatty liver changes on USG were included. Patients were categorized into four NAFLD grades (0–III) based on echogenicity, parenchymal texture, and liver-to-kidney contrast. Random blood glucose levels were assessed to determine diabetic status. Patients with alcohol consumption, hepatotoxic medication use, hypertension, or pregnancy were excluded. Results: Of the 120 participants, 58 were male and 62 were female, with a mean age of 59.6 years. A total of 90 patients (75%) were diagnosed with diabetes mellitus. The prevalence of diabetes increased progressively with fatty liver grade: 3 out of 19 (15.8%) in grade 0, 25 out of 31 (80.6%) in grade I, 32 out of 37 (86.5%) in grade II, and 30 out of 33 (90.9%) in grade III. Chi-square analysis showed a statistically significant association (p < 0.001) between NAFLD grade and diabetes prevalence. Conclusion: There is a significant linear association between NAFLD severity and the presence of diabetes mellitus. Ultrasonographic grading of fatty liver can serve as a predictive indicator for early metabolic risk screening and blood glucose monitoring in at-risk populations.