1313-P: The Prevalences of NAFLD and Liver Fibrosis Are High in Individuals with Type 1 Diabetes and Increase with Disease Progression

Abstract

Introduction: Approximately 30% of the global population has nonalcoholic fatty liver disease (NAFLD). This can result in nonalcoholic steatohepatitis (NASH) and liver fibrosis (2% in general population). NAFLD with fibrosis increases overall morbidity and mortality significantly. T2D increases the risk of fibrosis progression in NAFLD, but little is known about NAFLD in T1D. Therefore, the aim of this study was to assess the prevalence of NAFLD and liver fibrosis in T1D. Methods: In this cross-sectional study 453 individuals with T1D were included for analyses (41.0 ±14years old, 64% female, HbA1c 55.6 ±12mmol/mol, median T1D duration 14 [IQR: 6-29] years. Participants underwent a FibroScan® to assess liver stiffness, with a cut-off of 238 dB/m for steatosis and 7.0 kPa for fibrosis. Data analyses was performed in R studio, using a Students T- or Mann-Whitney U test, as appropriate. Results: Prevalence of liver steatosis was 29.5% and fibrosis was 7.7%. Steatosis was significantly higher in individuals with longer T1D duration (median:15 [IQR:7-25] vs. 23 [9-33] years), higher 24-hour insulin dose (34 [24-47] vs. 46 [33-62] units), higher BMI (mean 24.3±SD 3.5 vs. 27.9±4.6 kg/m2), higher CRP levels (1.0 [0.5-2.1] vs. 1.6 [0.8, 3.7] mg/L), higher triglyceride levels (0.6±0.3 vs. 0.8±0.5 mmol/L) and lower TIR (67 [51-82] vs. 62 [48-75] %). Presence of fibrosis was associated with a longer duration of T1D (16 [7-27] vs. 30 [20-39] years) a higher 24-hour insulin (36.0 [26-50] vs. 42 [34-63] units), higher BMI (25.1±4.1 vs. 27.8±4.6 kg/m2), higher CRP levels (1.2 [0.6-2.4] vs 1.5 [0.8-3.9] mg/L) and lower TIR (67 [51, 8] vs. 58 [46, 71] %). Conclusion: The prevalence of NAFLD and liver fibrosis was 7.7% in individuals with T1D. Duration of T1D, markers of insulin resistance, glycemic control and inflammation are likely contributors to this high prevalence and more attention should be paid to this possible complication. Disclosure C. Fuhri Snethage: None. A.S. Meijnikman: None. P. de Groen: None. C. Callender: None. E. Rampanelli: None. C.B. Brouwer: None. D. van Raalte: Consultant; Boehringer Ingelheim and Eli Lilly Alliance, AstraZeneca, Merck & Co., Inc. Research Support; Boehringer Ingelheim and Eli Lilly Alliance, AstraZeneca, Merck & Co., Inc. M. Nieuwdorp: Advisory Panel; caelus health. N. Hanssen: Research Support; Novo Nordisk. Consultant; Novo Nordisk. Funding DNF DON Grant 2020 (2020.10.002)