Abstract: Objective To explore the relationship between visceral fat area (VFA) and liver fibrosis in patients with metabolic associated fatty liver disease (MAFLD) and type 2 diabetes mellitus (T2DM). 
Methods In total, 418 patients with T2DM were included, and divided into T2DM group (n=136) and T2DM + MAFLD group (n=282)based on abdominal ultrasound. According to non-alcoholic fatty liver disease fibrosis score (NFS), T2DM-MAFLD group was subdivided into low-risk subgroup (n=94), moderate-risk subgroup (n=154), and high-risk subgroup (n=34). VFA and related serological indexes of those patients were determined. 
Results Compared with the T2DM group, patients in the T2DM+MAFLD group had significantly increased body mass index (BMI), waist circumference(WC), hip circumference (HC), VFA, subcutaneous fat area (SFA), triglyceride (TG), alanine transaminase(ALT), and albumin (Alb) but significantly shorter course of disease and significantly reduced high density lipoprotein cholesferol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Comparison of platelet (PLT) in T2DM+MAFLD subgroups showed the highest PLT in high-risk subgroup, followed by moderate-risk subgroup and low-risk subgroup; high-risk subgroup had significantly increased BMI and VFA, and significantly decreased TC, LDL-C and ALT, suggesting a significant difference (P＜0.05). VFA and SFA in T2DM+MAFLD groups were positively correlated with weight (W), BMI, white blood cell (WBC), ALT and AST, and negatively correlated with the course of disease and HDL-C. Logistic analysis showed that BMI, VFA, PLT, ALT, and Alb were the influencing factors for developing liver fibrosis in patients with T2DM+MAFLD.  
Conclusion The findings of this study show that the risk of liver fibrosis in patients with T2DM and MAFLD is associated with BMI, VFA, PLT, ALT, and Alb. 

Key words: diabetes mellitus, type 2, metabolicassociated fatty liver disease, hepatic fibrosis