Objective To analyze the related factors of carotid atherosclerosis in type 2 diabetes mellitus pa-tients complicated with nonalcoholic fatty liver disease .Methods 288 type 2 diabetes mellitus patients complicated with nonalcoholic fatty liver disease were divided into carotid atherosclerosis group (group A) and non-carotid athero-sclerosis group ( group B ) , according to whether they had carotid atherosclerosis .The related factors of these two groups,such as BMI,blood pressure,blood glucose,blood lipid,liver function were analyzed.Results The two groups had no significant differences in systolic pressure and diastolic pressure (P>0.05).ALT,BMI,HbA1c,FPG,TG,TC, AST of group A were significantly higher than group B [ALT (55.12 ±9.13)mmol/L vs (36.22 ±8.76)mmol/L, BMI (28.48 ±4.69)kg/m2 vs (23.96 ±3.73)kg/m2,HbA1c (8.57 ±1.69)mmol/L vs (7.62 ±1.28)mmol/L, FPG (9.36 ±2.24)mmol/L vs (8.67 ±1.98)mmol/L,TG (2.12 ±0.38)mmol/L vs (1.23 ±0.17)mmol/L,TC (5.56 ±1.25)mmol/L vs (4.31 ±1.09)mmol/L,AST (25.34 ±5.23)mmol/L vs (21.19 ±4.71)mmol/L](t=17.564,8.726,5.163,2.694,8.788,6.894,all P<0.01).The multiple stepwise regression analysis showed that there was a positive correlation between ALT and BMI (r=0.132,P<0.01),a negative correlation between ALT and AST(r=-0.091,P<0.01).Conclusion The level of ALT could be used as a risk index to judge whether the type 2 diabetes mellitus patients complicated with nonalcoholic fatty liver disease had carotid atherosclerosis .