Usefulness of ultrasonographic estimation of preperitoneal and subcutaneous fat thickness in the diagnosis of nonalcoholic fatty liver disease in diabetic patients.

Abstract

Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) have been regarded as the hepatic manifestation of metabolic syndrome. Abdominal wall fat index (AFI), defined as the ratio of preperitoneal and subcutaneous fat thickness in the abdomen estimated by ultrasonography (US), has been shown to be useful in screening for disorders related to metabolic syndrome. We investigated the relation between AFI and NAFLD/NASH in diabetic patients. The degree of fat accumulation in the liver and the thickness of preperitoneal and subcutaneous fat were determined by US in 340 diabetic patients. An NAFLD fibrosis score (NAFLD-FS) was used to assess the advancement of hepatic fibrosis in NAFLD patients. Of all 340 subjects, 209 (61 %) were diagnosed with NAFLD by US. AFI of NAFLD subjects was significantly higher than that of non-NAFLD subjects. Of the 209 subjects with NAFLD, 31 (15 %) were shown to have advanced NASH fibrosis according to NAFLD-FS. Multivariate analysis identified AFI as a significant predictor of advanced fibrosis. AFI easily obtained by US was significantly related to the presence of NAFLD and/or advanced hepatic fibrosis in diabetic patients.