Objective:To study the relationship between the insulin-like growth factor 1(IGF-1)and insulin resistance(IR)in type 2 diabetic patients(T2DM)with nonalcoholic fatty liver disease(NAFLD). Methods:The levels of IGF-1,growth hormone(GH) in blood serum of 46 T2DM patients with NAFLD, 45 T2DM patients, 42 healthy persons were determined by chemiluminescence. The levels of fasting plasma glucose(FPG),fasting insulin(FINS),cholesterol(CH),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),alaninea minotransferase(ALT),aspartate aminotransferase(AST) and -酌-glutamy transpeptidase (GGT) were determined. Ultrasonic inspection of liver was performed. Insulin resistance was assessed by insulin resistance index(HOMA-IR). Results:The level of IGF-1 in T2DM group with NAFLD was lower than that of T2DM group without NAFLD and healthy control group(83.49 ± 43.50 vs 130.34 ± 57.21,182.20 ± 57.15;P < 0.05). The level of HOMA-IR in T2DM group with NAFLD were higher than that of T2DM group without NAFLD and normal control subjects(5.70 ± 2.80 vs 2.82 ± 1.53,1.24 ± 0.45;P < 0.05). The levels of ALT,AST,GGT,TG,CH,LDL-C in group of T2DM with NAFLD were higher than that in other two groups(P < 0.05). The levels of TG,CH,LDL-C in the groups of T2DM with NAFLD and T2DM without NAFLD were higher than that of control subjects(P < 0.05). Correlation analysis showed that the levels of IGF-1 were negatively correlated with HOMA-IR(r = -0.387,P < 0.05). Conclusion:The level of IGF-1 significantly decreased in T2DM patients with NAFLD. Serum IGF-1 was negatively correlated with insulin resistance. Serum IGF-1 may play an important role in the development of T2DM with NAFLD.