Objective:To investigate the relationship of serum ferritin and insulin resistance in patients with non-alcoholic fatty liver disease(NAFLD) alone and NAFLD combined with type 2 diabetes. Methods:A total of 41 with NAFLD alone,76 NAFLD patients with type 2 diabetes and 60 healthy controls were studied. Abdominal ultrasound was taken for fatty liver examination. Serum ferritin and insulin levels were determined by radioimmunoassay(RIA). Insulin resistance indexes were assessed by the homeostasis assessment-insulin resistance(HOMA-IR). Other biochemical variables were measured by routine methods. Results:Compared with healthy controls, the BMI,ALT,AST,TC,LDL,FBG,FINS,HOMA IR,HbA1C,UAlb/UCr and SF significantly increased in NAFLD patient with type 2 diabetes. Compared with NAFLD patients, insulin resistance was more serious in NAFLD with type 2 diabetes. Correlation analysis showed FBG,HOMA IR and HbA1C were closely related with SF. Conclusion:Serum iron metabolism is closely related with insulin resistance. Therefore,reduce of insulin resistance and correction of SF are important to prevent NAFLD.