The aim of the work was to optimize the methods of early detection of NAFLD. Materials and methods: A total of 582 patients with type 2 diabetes mellitus were examined. The average age of the surveyed was 48.1 ± 11.6 years, 68% of the surveyed were women. All patients were calculated using the FIB-4 scale, NAFLD score, BMI. Results: significant factors determining the risk of developing NAS are fasting hyperglycemia (above 6.1 mmol / L), female sex, total cholesterol level above 5.2 mmol / L, HDL below 1.2 mmol / L for women, VLDL above 0.55 mmol / L, TG above 1.7 mmol /L, ferritin above 400 mmol / L for men, NAFLD score above 2 points, BMI above 25 kg / m2. The factors are listed as their contribution to the risk of developing NAS increases. Conclusions: To prevent the development and progression of steatosis, it is important to achieve target values of glycemia and lipid spectrum indicators, as well as achieve weight loss.