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Objectives Many cross-sectional and prospective studies have shown that type 2 diabetes mellitus is a probable cause of non-alcoholic fatty liver disease (NAFLD) with fibrosis and cirrhosis. This research aimed to examine the plasma amino transaminase levels as biomarkers of NAFLD and their association with apoptosis markers (Fas and FasL) as well as the lipid profile in type II diabetic patients. Methods This cross-sectional comparative study included 120 type II diabetic and 100 non-diabetic patients, and their defined biomarkers were studied. Results The results showed that the mean ALT levels, FasL and triglyceride/high density lipoprotein (TG/HDL) ratio were significantly higher in patients with type II diabetics. According to the Atherogenic Index of Plasma (Log TG/HDL), approximately 45% of diabetic patients had a high risk and 11% had an intermediate risk of developing cardiovascular disease. Alanine aminotransferase (ALT) was significantly and positively correlated with FasL, TG, glucose levels and body mass index (BMI) in diabetic patients. Moreover, TG was positively correlated with blood glucose levels and BMI, whereas HDL was negatively correlated with FasL and ALT. Conclusion The results of this study showed that in diabetic patients, elevated ALT levels and FasL may play a role in the risk of developing liver disease and could be used as a distinct marker of NAFLD, indicating liver injury. Moreover, atherogenic dyslipidaemia is a prominent feature in type II diabetes mellitus. Low HDL-c is closely associated with hypertriglyceridemia with an increased risk of cardiovascular disease and NAFLD in diabetics.

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