Focus on Visceral Fat Screening in Nonobese Patients With Type 2 Diabetes to Prevent Nonalcoholic Fatty Liver

Objective: To identify risk factors associated with nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes (T2DM) and provide a basis for improved prevention and treatment strategies for NAFLD. Methods: A total of 156 hospitalized patients with T2DM were enrolled and divided into NAFLD and non‐NAFLD groups (75 and 81 patients, respectively) based on the ultrasonic diagnosis results. Biochemical data were collected from all patients. A bioelectrical impedance analyzer (OMRON, HDS‐2000 DUALSCANR) was used to analyze visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in the abdomen. Statistical analyses were conducted using SPSS 22.0 software. Results: Statistically significant differences were observed between the NAFLD and non‐NAFLD groups in body weight, body mass index (BMI), waist and hip circumference (WC and HC), waist‐to‐hip ratio (WHR), fasting C‐peptide (FCP), alanine aminotransferase (ALT), gamma‐glutamyl transpeptidase (GGT), total triglycerides (TG), high‐density lipoprotein cholesterol (HDL‐C), apolipoprotein B (apoB), superoxide dismutase (SOD), free fatty acids (FFA), VAT, and SAT (all p < 0.05). VAT was positively correlated with BMI ( r = 0.703, p < 0.001), WC ( r = 0.685, p < 0.001), HC ( r = 0.547, p < 0.001), SAT ( r = 0.774, p < 0.001), TG ( r = 0.365, p < 0.001), FCP ( r = 0.287, p < 0.001), ALT ( r = 0.282, p < 0.001), and GGT ( r = 0.273, p = 0.001) and negatively correlated with HDL‐C ( r = −0.201, p = 0.012). Multivariable logistic regression analysis indicated that VAT and FFA are independent influencing factors for NAFLD ( p < 0.01). A receiver operating characteristic curve showed that the sensitivity and specificity of VAT for predicting NAFLD in T2DM were 88.0% and 57.8%, respectively. Conclusions: VAT and FFA are independent risk factors for NAFLD in patients with T2DM, with VAT serving as a reliable predictor for NAFLD screening. Screening for NAFLD should not be limited to overweight or obese individuals; attention should also be given to nonobese and lean patients.