International Journal of Health Sciences and Research · Nov 3, 2026
Prediabetes and Fatty Liver: A Cross-Sectional Study to Assess the Frequency and Severity of Fatty Liver Detected During Preventive Abdominal Ultrasonography and Their Association with HbA1c
By Muthuvel D, Soundarapandian A, Babu B
Introduction: Incidental abnormalities are frequently encountered during imaging performed for preventive health assessment. Their clinical importance ranges from negligible findings to abnormalities requiring prompt evaluation. Abdominal ultrasonography is particularly suitable for health-check programs because it is non-invasive, readily available, and free of ionizing radiation. This study assessed the frequency and severity of incidental findings detected during preventive abdominal ultrasonography and examined their association with HbA1c. Materials and Methods: This retrospective cross-sectional study included adults who underwent abdominal ultrasonography during routine master health check-ups at the Department of Radiology, Panimalar Medical College and Research Institute, Chennai, between January and December 2023. Ultrasound reports were anonymized and reviewed. Incidentally detected fatty liver were classified by ultrasound and subjectively graded as Grade 1 (increased echogenicity), Grade 2 (portal wall echogenicity poorly seen) or Grade 3 (poor visualization of diaphragm and portal vein). Associations with HbA1c were assessed using descriptive statistics, Pearson correlation, chi-square testing, and multivariable logistic regression in SPSS version 25.0. Results: Of 2,312 participants, 1,315 (56.9%%) had fatty liver. The most frequently reported abnormalities included fatty liver (56.9%), renal cysts (7.8%), and gallstones (5.9%). In the study dataset, 61% were assigned to the normoglycemic group and 39% to the prediabetic group according to the HbA1c categorization. Age and HbA1c were reported as significant predictors of Grade 3 findings. In the fatty-liver model, each one-unit increase in HbA1c was associated with an approximately 10.5% increase in odds of fatty liver (p=0.004). Conclusion: Incidental fatty liver was common in adults undergoing preventive abdominal ultrasonography. Fatty liver, renal cysts, and gallstones were among the commonest findings. Higher HbA1c and older age were associated with clinically significant findings, while sex was not identified as a significant predictor. Standardized reporting and follow-up pathways may improve the clinical utility of preventive imaging. Key words: abdominal ultrasonography; incidental findings; preventive health check-up; HbA1c; diabetes mellitus; fatty liver; renal cyst; gallstones