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Preperitoneal fat as a non‐invasive marker of increased risk of severe non‐alcoholic fatty liver disease in patients with type 2 diabetes
Author(s) -
Parente Daniella Braz,
Oliveira Neto Jaime Araújo,
Brasil Pedro Emmanuel Alvarenga Americano,
Paiva Fernando Fernandes,
Ravani José Pedro Rodrigues,
Gomes Marilia Brito,
Lanzoni Valeria,
Campos Carlos Frederico Ferreira,
MachadoSilva Lilian,
Perez Renata Mello,
Rodrigues Rosana Souza
Publication year - 2018
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13903
Subject(s) - steatohepatitis , medicine , fatty liver , steatosis , gastroenterology , liver biopsy , fibrosis , type 2 diabetes , diabetes mellitus , chronic liver disease , insulin resistance , magnetic resonance imaging , pathology , disease , biopsy , insulin , endocrinology , radiology , cirrhosis
Abstract Background and Aim Fat distribution may have prognostic value in the evaluation of non‐alcoholic fatty liver disease. This study was conducted to evaluate associations of magnetic resonance imaging‐measured abdominal fat areas with steatosis, steatohepatitis, and fibrosis, assessed histopathologically, in patients with type 2 diabetes. Methods This prospective study included 66 patients with type 2 diabetes (12 males, 54 females, age 26–68 years), without chronic liver disease of other causes. Axial dual‐echo magnetic resonance images were acquired. Visceral, subcutaneous, and preperitoneal fat areas were measured using Osirix software. Liver biopsy specimens were obtained from all patients and examined histopathologically to evaluate steatosis, steatohepatitis, and fibrosis. Linear (for steatosis) and logistic (for steatohepatitis and fibrosis) regression models were fitted for the outcomes. R2 was used as a measure of how much model variance the predictors explained and to compare different predictors of the same outcome. Results Visceral and preperitoneal fat areas correlated well with histopathologically determined liver steatosis grade (both P = 0.004) and liver fibrosis ( P = 0.008 and P = 0.037, respectively). All fat areas correlated well with steatohepatitis ( P ≤ 0.002). Preperitoneal and visceral fat areas were the best predictors of steatohepatitis (R2 = 0.379) and fibrosis (R2 = 0.181), respectively. Conclusions Visceral fat area was the best predictor of fibrosis in patients with type 2 diabetes. Preperitoneal fat area was the best predictor of steatohepatitis and is a potential new non‐invasive marker for use in the screening of these patients to detect more aggressive forms of non‐alcoholic fatty liver disease.