Increased visceral adiposity with normal weight is associated with the prevalence of non-alcoholic fatty liver disease in Japanese patients with type 2 diabetes

Aims/Introduction: To investigate the impact of increased visceral adiposity with normal weight (OB[−]VA[+]) on the prevalence of non-alcoholic fatty liver disease in patients with type 2 diabetes. Materials and Methods: This was a cross-sectional study of 140 Japanese patients with type 2 diabetes (mean age 65 ± 11 year; 44.6% women). Visceral fat area (VFA; cm²) and liver attenuation index (LAI) were assessed by abdominal computed tomography. The patients were divided into four groups by VFA and body mass index (BMI; kg/m²) as follows: BMI <25 kg/m² and VFA <100 cm² (OB[−]VA[−]), BMI ≥25 kg/m² and VFA <100 cm² (OB[+]VA[−]), BMI <25 kg/m² and VFA ≥100 cm² (OB[−]VA[+]), and BMI ≥25 kg/m² and VFA ≥100 cm² (OB[+]VA[+]). Multivariate linear regression and logistic regression analysis were carried out to determine the impact of OB(−)VA(+) on LAI. Results: In the present study, 25.0% were OB(−)VA(+) patients, where the LAI levels were lower (1.09 ± 0.22) than those in OB(−)VA(−) patients (1.23 ± 0.15), and were equivalent to those in OB(+)VA(+) patients (1.03 ± 0.26). In multivariate linear regression analysis, OB(−)VA(+) was independently associated with LAI (standardized β−0.212, P = 0.014). In multivariate logistic regression analysis, OB(−)VA(+) was a significant predictor of LAI <0.9 (odds ratio 5.88, 95% confidence interval 1.03−33.52, P = 0.046). Conclusions: The present study provides evidence that increased visceral adiposity with normal weight is a strong predictor for the prevalence of non-alcoholic fatty liver disease in Japanese patients with type 2 diabetes.