Objective To investigate the changes of serum progranulin in type 2 diabetic (T2DM) patients with nonalcoholic fatty liver disease (NAFLD) and the relevant clinical significance. Methods The clinical data were subjected to cross-sectional analysis. Totally 116 T2DM patients were randomly selected and assigned to the NAFLD group (n=68) and non-NAFLD group (n=48). The levels of serum progranulin, glycosylated hemoglobin A1c(HbA1c),liver enzymes (ALT, AST, AKP), uric acid (UA), lipids(TG, TC, LDL-C, HDL-C),fasting blood-glucose (FBG), and fasting insulin (FINS) were assessed. Homeostasis model assessment of insulin resistance (HOMA-IR)was calculated. The height, weight, waist circumference and hip circumference were measured, and the body mass index(BMI) and waist-to-hip ratio (WHR) were calculated. The multiple stepwise regression analysis was used to detect the association of progranulin with the above metabolic parameters. The logistic regression was used to analyze the factors influencing NAFLD in patients with T2DM. Results (1)Compared with non-NAFLD group, the levels of BMI, waist circumference, hip circumference, WHR and serum FINS, HOMA-IR, TG, ALT, and AST were significantly higher in the NAFLD group (P<0.05), while the level of HDL-C was significantly lower (P<0.05)in NAFLD group. (2)Serum levels of progranulin were significantly higher in patients with NAFLD than in those with non-NAFLD (P<0.01). (3)Multiple stepwise regression analysis suggested that BMI, HOMA-IR and TG were the independent factors influencing serum progranulin level. (4)Logistic regression analysis showed that progranulin, BMI and ALT were the independent risk factors influencing NAFLD in T2DM patients. Conclusion Serum progranulin level is increased in T2DM patients combined with NAFLD. High level of progranulin is an independent risk factor for the presence of NAFLD in T2DM patients. Progranulin might be an important serological marker of NAFLD in T2DM patients.