TY - JOUR
T1 - Prevalence of non-alcoholic fatty liver disease (NAFLD) and its association with surrogate markers of insulin resistance in patients with type 1 diabetes
AU - de Vries, Marieke
AU - Westerink, Jan
AU - El-Morabit, Fatima
AU - Kaasjager, H. A.H.(Karin)
AU - de Valk, Harold W.
N1 - Funding Information:
The authors thank the study participants and K.E. van Erpecum, MD PhD, gastroenterologist, for providing the use of transient elastography. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
Publisher Copyright:
© 2022 The Authors
PY - 2022/4
Y1 - 2022/4
N2 - Aims: Assess prevalence of hepatic steatosis (HS) and of fibrosis in an unselected population of patients with type 1 diabetes. Describe their clinical profile and explore the association between insulin resistance and NAFLD as secondary objectives. Methods: We prospectively assessed NAFLD by transient elastography in adult outpatients with type 1 diabetes. Patients were eligible if they did not have any known secondary cause of liver disease. NAFLD was defined as HS with or without fibrosis/cirrhosis. Associations between estimated glucose disposal rate (eGDR) and metabolic syndrome, as surrogate markers of insulin resistance, and NAFLD were explored using multivariate logistic regression models, adjusting for age, sex and diabetes duration. Results: We enrolled 150 consecutive subjects (age 47 ± 14 years, male 55%, diabetes duration 25 ± 14 years, median BMI 25 kg/m2). NAFLD prevalence was 20% (n = 30). Thirty patients (20%) had HS. Five patients (3.3%) had HS with fibrosis. eGDR and metabolic syndrome were statistically significantly associated with the presence of NAFLD (OR 0.62, 95% CI 0.49–0.77, OR 7.62, 95% CI 2.95–19.77). Conclusions: NAFLD prevalence in patients with type 1 diabetes is considerable, mainly restricted to isolated HS, while fibrosis is rare. Insulin resistance is associated with NAFLD in patients with type 1 diabetes.
AB - Aims: Assess prevalence of hepatic steatosis (HS) and of fibrosis in an unselected population of patients with type 1 diabetes. Describe their clinical profile and explore the association between insulin resistance and NAFLD as secondary objectives. Methods: We prospectively assessed NAFLD by transient elastography in adult outpatients with type 1 diabetes. Patients were eligible if they did not have any known secondary cause of liver disease. NAFLD was defined as HS with or without fibrosis/cirrhosis. Associations between estimated glucose disposal rate (eGDR) and metabolic syndrome, as surrogate markers of insulin resistance, and NAFLD were explored using multivariate logistic regression models, adjusting for age, sex and diabetes duration. Results: We enrolled 150 consecutive subjects (age 47 ± 14 years, male 55%, diabetes duration 25 ± 14 years, median BMI 25 kg/m2). NAFLD prevalence was 20% (n = 30). Thirty patients (20%) had HS. Five patients (3.3%) had HS with fibrosis. eGDR and metabolic syndrome were statistically significantly associated with the presence of NAFLD (OR 0.62, 95% CI 0.49–0.77, OR 7.62, 95% CI 2.95–19.77). Conclusions: NAFLD prevalence in patients with type 1 diabetes is considerable, mainly restricted to isolated HS, while fibrosis is rare. Insulin resistance is associated with NAFLD in patients with type 1 diabetes.
KW - Fibrosis
KW - Insulin resistance
KW - NAFLD
KW - Non-alcoholic fatty liver disease
KW - Transient elastography
KW - Type 1 diabetes
KW - Prevalence
KW - Humans
KW - Middle Aged
KW - Insulin Resistance
KW - Male
KW - Metabolic Syndrome/complications
KW - Diabetes Mellitus, Type 1/complications
KW - Liver Cirrhosis/epidemiology
KW - Biomarkers
KW - Adult
KW - Non-alcoholic Fatty Liver Disease/complications
UR - http://www.scopus.com/inward/record.url?scp=85126915067&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2022.109827
DO - 10.1016/j.diabres.2022.109827
M3 - Article
C2 - 35283265
AN - SCOPUS:85126915067
SN - 0168-8227
VL - 186
SP - 1
EP - 7
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 109827
ER -