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In 137 patients with diabetes mellitus, non-alcoholic fatty liver disease and with combination of these diseases there had been studied the pathogenetic mechanisms of hyperhomocysteinemia influence on formation of non-alcoholic fatty liver disease. The following disorders were revealed: the augmentation of homocysteine content; atherogenic types of dyslipidemia; disorders of bile-secreting liver function, of all types of metabolism; development of endothelial dysfunction; disorders of lipid peroxidation system and antioxidant activity in patients with diabetes mellitus, non-alcoholic fatty liver disease, that led to disorder of hepatocytes integrity, development of fatty hepatosis and increase of incidence of late complications of diabetes mellitus.