title: Type 2 diabetes mellitus is associated with the fibrosis severity in patients with nonalcoholic fatty liver disease in a large retrospective cohort of Japanese patients.
abstract: BACKGROUND
  The prevalence of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome have been increasing worldwide. The associations between metabolic factors and the histologic severity of NAFLD have not yet been clarified. Therefore, we studied the relationships between relevant metabolic factors and the histological severity of NAFLD.
  
  
  METHODS
  In a cross-sectional multicenter study conducted in Japan, we examined 1,365 biopsy-proven NAFLD patients. The frequencies of underlying lifestyle-related diseases and their relationships to the NAFLD histology were investigated.
  
  
  RESULTS
  The hepatic fibrosis stages (Stage 0/1/2/3/4) were 22.6/34.1/26.7/14.5/2.1 (%) in the male patients, and 16.2/31.7/23.9/21.6/6.6 (%) in the female patients. Dyslipidemia was present in 65.7% (hypertriglyceridemia, 45.3%; increased low-density lipoprotein cholesterol, 37.5%; decreased high density lipoprotein cholesterol, 19.5%) of patients. Hypertension was present in 30.2%, and diabetes mellitus (DM) in 47.3%. The fibrosis stage increased with age, especially in postmenopausal females. The body mass index was positively correlated with the fibrosis stage. Deterioration of glucose control was positively correlated with the fibrosis stage, this correlation being more prominent in females. Multivariate analysis identified age and DM as significant risk factors for advanced fibrosis. No significant correlation of the fibrosis stage was observed with hypertension. There was a negative correlation between the serum triglyceride levels and the fibrosis stage.
  
  
  CONCLUSIONS
  DM appeared to be a significant risk factor for advanced fibrosis in patients with NAFLD, and would therefore need to be properly managed to prevent the progression of NAFLD.
authors.affiliation: Department of Medicine and Molecular Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakahara
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hyogo
authors.forename: Masato
authors.initials: M
authors.lastname: Yoneda
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sumida
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Eguchi
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ono
authors.forename: Takumi
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Kento
authors.initials: K
authors.lastname: Imajo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.forename: Saiyu
authors.initials: S
authors.lastname: Tanaka
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kanemasa
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Keizo
authors.initials: K
authors.lastname: Anzai
authors.forename: Toshiji
authors.initials: T
authors.lastname: Saibara
authors.forename: Michio
authors.initials: M
authors.lastname: Sata
authors.forename: Atushi
authors.initials: A
authors.lastname: Nakajima
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Itoh
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okanoue
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D044466:Asian People; D001706:Biopsy; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D050171:Dyslipidemias / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D007564:Japan; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000208:ethnology / Q000209:etiology* / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000208:ethnology / Q000473:pathology; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index