title: Estimation of visceral fat and fatty liver disease using ultrasound in patients with diabetes.
abstract: OBJECTIVE
  Fatty liver disease is the most commonly encountered form of chronic liver dysfunction in routine medical care and is closely associated with type 2 diabetes. We aimed to elucidate how the use of new medications affects the incidence of fatty liver disease and amount of visceral fat, both of which are associated with diabetes.
  
  
  METHODS
  Abdominal ultrasonography was performed to assess the preperitoneal fat thickness (PFT) and presence of fatty liver. The PFT, body mass index (BMI) and waist circumference were used to investigate the rate and development of fatty liver disease in each group. A multivariate analysis with multiple logistic regression was performed using the PFT and presence of fatty liver disease as dependent variables.
  
  
  METHODS
  We evaluated 202 patients treated at the Onitsuka Clinic. The subjects were divided into three subgroups (non-diabetic and diabetic with or without treatment with antidiabetic medications).
  
  
  RESULTS
  Positive correlations between the PFT, BMI, and waist circumference were observed. No increases in the prevalence of fatty liver disease were observed in the medicated diabetic group, even when the PFT levels were high. A multivariate analysis with multiple logistic regression revealed that visceral fat accumulation was inhibited in women and those taking statins or thiazolidines and aggravated in men and those with obesity or an increased waist circumference. Obesity was an aggravating factor for fatty liver disease, and biguanides were useful as counteractants.
  
  
  CONCLUSIONS
  Measuring the PFT is effective for screening metabolic syndrome and evaluating diabetes, dyslipidemia and hypertension associated with fatty liver disease. Clinically, fatty liver progression to non-alcoholic steatohepatitis (NASH) may be prevented by tackling obesity and administering appropriate medications.
authors.affiliation: Onitsuka Internal Medicine and Gastroenterology Clinic, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Onitsuka
authors.forename: Fuminao
authors.initials: F
authors.lastname: Takeshima
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
mesh_terms: D000368:Aged; D001645:Biguanides / Q000627:therapeutic use; D001823:Body Composition; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D066273:Diet, Western / Q000009:adverse effects*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging* / Q000378:metabolism; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D053778:Thiazolidines / Q000008:administration & dosage / Q000009:adverse effects; D014463:Ultrasonography; D055105:Waist Circumference
chemical_list: D001645:Biguanides; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D053778:Thiazolidines