ONO Masafumi    Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine    Position
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Type 2 diabetes mellitus is associated with the fibrosis severity in patients with nonalcoholic fatty liver disease in a large retrospective cohort of Japanese patients.
Journal	Formal name：Journal of gastroenterology Abbreviation：J Gastroenterol ISSN code：14355922/09441174
Domestic / Foregin	Domestic
Volume, Issue, Page	49(11),pp.1477-84
Author and coauthor	Nakahara Takashi, Hyogo Hideyuki, Yoneda Masato, Sumida Yoshio, Eguchi Yuichiro, Fujii Hideki, Ono Masafumi, Kawaguchi Takumi, Imajo Kento, Aikata Hiroshi, Tanaka Saiyu, Kanemasa Kazuyuki, Fujimoto Kazuma, Anzai Keizo, Saibara Toshiji, Sata Michio, Nakajima Atushi, Itoh Yoshito, Chayama Kazuaki, Okanoue Takeshi,
Publication date	2014/11
Summary	BACKGROUND:The prevalence of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome have been increasing worldwide. The associations between metabolic factors and the histologic severity of NAFLD have not yet been clarified. Therefore, we studied the relationships between relevant metabolic factors and the histological severity of NAFLD.METHODS:In a cross-sectional multicenter study conducted in Japan, we examined 1,365 biopsy-proven NAFLD patients. The frequencies of underlying lifestyle-related diseases and their relationships to the NAFLD histology were investigated.RESULTS:The hepatic fibrosis stages (Stage 0/1/2/3/4) were 22.6/34.1/26.7/14.5/2.1 (%) in the male patients, and 16.2/31.7/23.9/21.6/6.6 (%) in the female patients. Dyslipidemia was present in 65.7% (hypertriglyceridemia, 45.3%; increased low-density lipoprotein cholesterol, 37.5%; decreased high density lipoprotein cholesterol, 19.5%) of patients. Hypertension was present in 30.2%, and diabetes mellitus (DM) in 47.3%. The fibrosis stage increased with age, especially in postmenopausal females. The body mass index was positively correlated with the fibrosis stage. Deterioration of glucose control was positively correlated with the fibrosis stage, this correlation being more prominent in females. Multivariate analysis identified age and DM as significant risk factors for advanced fibrosis. No significant correlation of the fibrosis stage was observed with hypertension. There was a negative correlation between the serum triglyceride levels and the fibrosis stage.CONCLUSIONS:DM appeared to be a significant risk factor for advanced fibrosis in patients with NAFLD, and would therefore need to be properly managed to prevent the progression of NAFLD.
DOI	10.1007/s00535-013-0911-1
PMID	24277052