title: Clinical and biochemical determinants of the extent of liver steatosis in type 2 diabetes mellitus.
abstract: OBJECTIVE
  Nonalcoholic fatty liver disease is very frequent in both type 2 diabetes mellitus (T2DM) and the metabolic syndrome (MS), which share clinical and metabolic characteristics. Whether and to which extent these characteristics can predict the degree of liver steatosis are not entirely clear.
  
  
  METHODS
  We determined liver fat (divided into four classes) by standard sonographic images, and clinical and biochemical variables, in 60 consecutive patients with T2DM and with features of the MS. We examined both simple and multiple correlations between the degree of liver steatosis and the variables measured.
  
  
  RESULTS
  Increased liver fat (defined as >5% of liver mass) was detected in 88% of the participants. Using simple regression analysis, the class of steatosis correlated positively with BMI, waist, number of factors of the MS, sex (female>male), diastolic blood pressure, insulin resistance, metabolic control, inflammation, C-reactive protein, fibrinogen, and leptin, whereas it correlated negatively with high-density lipoprotein-cholesterol. Using multiple regression analysis, only metabolic control, insulin resistance and/or plasma insulin, and waist, remained correlated significantly with the degree of steatosis. Using an ordered probit statistical model, metabolic control, waist, and insulin concentration predicted the steatosis class in 58% of the cases (≤97% with allowance for one class in either excess or deficit).
  
  
  CONCLUSIONS
  In patients with T2DM, the extent of liver steatosis is correlated with variables associated with metabolic control and features of the MS. The combination of metabolic control, visceral obesity, and insulin resistance may reasonably predict the degree of liver steatosis in T2DM.
authors.affiliation: aDepartment of Medicine, Metabolism Division bDepartment of Medicine, 5th Internal Medicine, University of Padova, Padova cDepartment of Economics, University Ca' Foscari Venice, Venice, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Cosma
authors.forename: Diego
authors.initials: D
authors.lastname: Cecchet
authors.forename: Silvia
authors.initials: S
authors.lastname: Gaiani
authors.forename: Anna
authors.initials: A
authors.lastname: Coracina
authors.forename: Paolo
authors.initials: P
authors.lastname: Pellizzari
authors.forename: Claudio
authors.initials: C
authors.lastname: Pizzi
authors.forename: Nicola
authors.initials: N
authors.lastname: Veronese
authors.forename: David
authors.initials: D
authors.lastname: Sacerdoti
authors.forename: Paolo
authors.initials: P
authors.lastname: Tessari
mesh_terms: D050154:Adiposity / Q000502:physiology; D000368:Aged; D000886:Anthropometry / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications; D008875:Middle Aged; D015233:Models, Statistical; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D014463:Ultrasonography; D055105:Waist Circumference
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human