Exploring Ultrasonography Reliability and Affordability for NAFLD Grading: Insights From Liver Biomarker’s Correlation in Pakistan

Marwa Parveen; Hamna Aleem; Qurat ul Ain; Aimen Javed; Alishba Asghar; Durre Nayyab; Maisoon Khawar; Sidra Aslam

doi:10.61919/xsarqj32

Authors

Marwa Parveen University of Management and Technology, Lahore, Pakistan Author
Hamna Aleem University of Management and Technology, Lahore, Pakistan Author
Qurat ul Ain University of Management and Technology, Lahore, Pakistan Author
Aimen Javed University of Management and Technology, Lahore, Pakistan Author
Alishba Asghar University of Management and Technology, Lahore, Pakistan Author
Durre Nayyab University of Management and Technology, Lahore, Pakistan Author
Maisoon Khawar University of Management and Technology, Lahore, Pakistan Author
Sidra Aslam University of Management and Technology, Lahore, Pakistan Author

DOI:

https://doi.org/10.61919/xsarqj32

Keywords:

Non-alcoholic fatty liver disease, ultrasonography, liver enzymes, alanine aminotransferase, metabolic syndrome, Pakistan.

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is a common metabolic liver disorder associated with diabetes mellitus, hypertension, dyslipidemia, obesity, sedentary lifestyle, and unhealthy dietary patterns. In resource-limited settings, abdominal ultrasonography and routine liver function tests may provide a practical approach for early assessment and monitoring of NAFLD. Objective: This study aimed to evaluate the relationship between ultrasound-based NAFLD grading and selected biochemical liver parameters among adults in Pakistan. Methods: This retrospective cross-sectional analytical study included 190 adults aged 18–70 years who underwent abdominal ultrasonography and liver function testing at selected hospitals and laboratories in Punjab, Pakistan. Patients with hepatitis B or C, alcoholic fatty liver disease, chronic liver disease, or drug-related liver disease were excluded. NAFLD was graded on ultrasound as Grade I, II, or III. Biochemical parameters included alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, and serum albumin. Descriptive statistics and correlation analysis were performed using SPSS. Results: Of 190 participants, 96 (50.5%) were female and 94 (49.5%) were male, with a mean age of 40.84 ± 13.79 years. Grade I NAFLD was most frequent, affecting 115 participants (60.5%), followed by Grade II in 56 (29.5%) and Grade III in 19 (10.0%). ALT showed the strongest positive correlation with NAFLD grade (r = 0.494, p < 0.05), while AST (r = 0.055) and ALP (r = 0.109) showed weaker positive associations. Albumin showed a weak negative correlation (r = −0.181, p = 0.013), whereas bilirubin was not significantly correlated (r = 0.136, p = 0.138). Conclusion: Ultrasound-based NAFLD severity was associated with selected liver biochemical changes, particularly ALT elevation. Combining abdominal ultrasonography with routine liver function tests may support practical early assessment and monitoring of NAFLD in resource-limited clinical settings.

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