Aim: To explore data on non alcoholic fatty liver disease. For this systematic review, our major purpose is to compare grading of fatty liver disease diagnosed on ultrasound with cholesterol level and liver enzymes.

Methodology: For this study, total 25 studies were included which follow the Preferred Reporting Items guideline for conducting this systematic review analysis (PRISMA). We search electronic articles from year 2008 to from year 2020 on PUB Med, online Willey library, and ScienceDirect site by using keywords related to sonographic imaging for fatty liver disease.

Results: These case studies shows that increasing grades of fatty liver disease are significantly associated with increasing value of total cholesterol levels and liver enzymes.Comparing the heterogeneity level of studies we observed that AST studies have 85% heterogeneity whereas 77% ALT data and 76% GGT data were similar to each other. On the other hand, we observed complete study 12 studies provide information related to TG, TC, HDL, and LDL respectively.

Conclusion: Our meta-analysis concluded that the severe cases of liver diseases need biopsies and histopathological examination. Though ultrasonography provides a complete liver picture with 84.8% sensitivity and 93.6% specificity which may help in many cases still the majority of the studies failed to observe steatosis, NAS score.

Keywords: Non alcoholic fatty liver disease(NAFLD),ultra sonography,lipid profile ,liver enzymes.