title: The impact of visceral fat in nonalcoholic fatty liver disease: cross-sectional and longitudinal studies.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease is increasing worldwide, and attention is being paid to its association with obesity and metabolic syndrome. The aim of this study was to elucidate the role of visceral fat accumulation in hepatic steatosis by cross-sectional and longitudinal studies.
  
  
  METHODS
  We enrolled 125 patients in a cross-sectional study and 28 patients in a longitudinal study and examined visceral and subcutaneous fat thickness, hepatic steatosis score, and biochemical parameters. In the longitudinal study, the influence of weight change on fat distribution and hepatic steatosis was investigated.
  
  
  RESULTS
  In the cross-sectional study, the severity of hepatic steatosis showed a significant positive correlation with body mass index, visceral fat thickness, serum albumin, alanine aminotransferase (ALT), cholinesterase, fasting insulin, and the homeostasis model assessment of insulin resistance. ALT, visceral fat thickness, and serum albumin were independent factors for hepatic steatosis. In the longitudinal study, visceral fat thickness fluctuated closely with changes in body weight, and had the strongest relationship with the change of hepatic steatosis by multivariate analysis.
  
  
  CONCLUSIONS
  Visceral fat was the most important factor for the development of hepatic steatosis. Visceral fat thickness can be measured by sonography easily, noninvasively, and repeatedly for assessment of central obesity and monitoring of the efficacy of treatment of nonalcoholic fatty liver disease.
authors.affiliation: Second Department of Internal Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-machi, Yonago 683-8504, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Koda
authors.forename: Manri
authors.initials: M
authors.lastname: Kawakami
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Murawaki
authors.forename: Miho
authors.initials: M
authors.lastname: Senda
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D015992:Body Mass Index; D001835:Body Weight; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012709:Serum Albumin; D050507:Subcutaneous Fat, Abdominal / Q000000981:diagnostic imaging; D014463:Ultrasonography
chemical_list: D012709:Serum Albumin; D000410:Alanine Transaminase