Abstract
BackgroundIncreased visceral adiposity is strongly associated with non-alcoholic fatty liver disease (NAFLD). However, little attention has been paid to the association between the change in subcutaneous adipose mass and the progression of non-alcoholic fatty liver disease (NAFLD). We aimed to investigate whether increased subcutaneous adipose tissue (gynoid fat mass) could be protective against the progression of NAFLD in Japanese patients with type 2 diabetes.MethodsThis is a retrospective observational study of 294 Japanese patients with type 2 diabetes (65 ± 10 years old, 40% female). Liver attenuation index (LAI) measured by abdominal computed tomography was used for the assessment of hepatic steatosis. Both gynoid (kg) and android (kg) fat masses were measured by the whole body dual-energy X-ray absorptiometry. One-year changes in LAI, gynoid, and android fat masses were evaluated in both male and female patients. Linear regression analysis with a stepwise procedure was used for the statistical analyses to investigate the association of the changes in gynoid and android fat masses with the change in LAI.ResultsLAI levels at baseline were 1.15 ± 0.31 and 1.10 ± 0.34 in female and male patients (p = 0.455). The change in gynoid fat mass was significantly and positively associated with the change in LAI in both univariate (standardized β 0.331, p = 0.049) and multivariate (standardized β 0.360, p = 0.016) models in the female patients. However, no significant association was observed in males. In contrast, the increase in android fat mass was significantly associated with the reduced LAI in both genders in the multivariate models (standardized β −0.651, p < 0.001 in females and standardized β −0.519, p = 0.042 in males).ConclusionsThis study provides evidence that increased gynoid fat mass may be protective against the progression of NAFLD in female Japanese patients with type 2 diabetes.
Highlights
Increased visceral adiposity is strongly associated with non-alcoholic fatty liver disease (NAFLD)
We have recently reported in a cross-sectional study that increased abdominal visceral fat is associated with hepatic fat accumulation regardless of body mass index (BMI) in Japanese patients with type 2 diabetes [14], suggesting that visceral adiposity may promote hepatic steatosis regardless of the weight of the person
We revealed the gender difference in longitudinal association of gynoid and android fat masses with the progression of NAFLD in patients with type 2 diabetes who are at a high risk for the initiation and progression of NAFLD
Summary
Increased visceral adiposity is strongly associated with non-alcoholic fatty liver disease (NAFLD). Little attention has been paid to the association between the change in subcutaneous adipose mass and the progression of non-alcoholic fatty liver disease (NAFLD). Diabetes and insulin resistance are associated with histological severity of NAFLD in patients with normal transaminase levels [10]. These previous reports [8,9,10] suggest the importance of evaluating for NAFLD in diabetic patients, especially those with metabolic syndrome
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