Background and Objectives: Nonalcoholic fatty liver disease (NAFLD) is strongly associated with metabolic abnormalities including dyslipidemia and insulin resistance. The present study aimed to characterize the patterns of metabolic abnormalities and HbA1c in NAFLD patients attending public hospitals in Erbil city and to examine their associations with hepatic steatosis severity.

Methods: A cross-sectional analytic design was employed in the present study that included 100 participants who were known to have NAFLD by ultrasound between October 1, 2025 and September 30, 2026. Participants' fasting lipid profiles and hemoglobin A1C were determined using enzymatic colorimetric methods and HPLC, respectively. Participants' hepatic steatosis was graded as mild (Grade I), moderate (Grade II), or severe (Grade III) via ultrasonography.

Results: The majority of participants had mild levels of hepatic steatosis (60%) and borderline dyslipidemia. Significant positive correlations were found between HbA1C and total triglycerides (r = 0.206, p = 0.039) and borderline correlation between HbA1C and grade of hepatic steatosis (r = 0.196, p = 0.051). No significant correlations were found between HbA1C and total cholesterol or LDL. In multivariable regression analysis, sex was the only statistically significant (B = 0.362, p = 0.009) independent predictor of HbA1C and no other variables were identified as significant predictors of dyslipidemia.

Conclusion: NAFLD patients demonstrated a predominantly mild metabolic disturbance, with TGs showing the clearest link to glycemic status. Routine metabolic assessment may help identify patients at higher risk of progression.