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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 ; cm 2 ) 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/m 2 ) as follows:  BMI  <25 kg/m 2  and  VFA  <100 cm 2  ( OB [−] VA [−]),  BMI  ≥25 kg/m 2  and  VFA  <100 cm 2  ( OB [+] VA [−]),  BMI  <25 kg/m 2  and  VFA  ≥100 cm 2  ( OB [−] VA [+]), and  BMI  ≥25 kg/m 2  and  VFA  ≥100 cm 2  ( 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.

journal of diabetes investigation

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