1366-P: Nonalcoholic Fatty Liver Disease in Young-Onset Type 2 Diabetes Mellitus—A New Epidemic?

Abstract

The prevalence of young-onset type 2 diabetes mellitus (YOT2DM), defined as T2DM diagnosed in adults <45 years old, is steadily increasing. Nonalcoholic fatty liver disease (NAFLD) is common in people with T2DM but its prevalence in YOT2DM is unknown. We therefore hypothesized that NAFLD is an emerging health concern in this population. A total of 161 adults aged 35-44 years with and without T2DM, underwent screening for NAFLD with laboratory tests and imaging by elastography (steatosis by controlled attenuation parameter [CAP]; fibrosis by liver stiffness measurement [LSM]). Of these, 25 (16%) had YOT2DM and 136 (84%) did not have diabetes mellitus (noDM). While obesity was very prevalent in the cohort (53%), those with YOT2DM had a higher BMI (35±7 vs. 31±7 kg/m2, p<0.01), and reported comorbidities more frequently: hypertension (48% vs. 24%, p=0.02) and atherogenic dyslipidemia (76% vs. 54%, p=0.04). Hepatic (HOMA-IR 4.6±2.8 vs 2.6±1.9, P<0.01) and adipose tissue (6.5±5.1 vs 3.9±3.5, p=0.01) insulin resistance were worse in people with YOT2DM. Adiponectin, a reflection of proper adipose tissue function, was lower in YOT2DM (4.2±2.3 vs 6.2±3.5 μg/mL, p=0.02). Hepatic steatosis (CAP ≥274 dB/m) was prevalent in both groups but higher in people with YOT2DM (64% vs. 47%), but much lower in people without obesity or diabetes (27%; p<0.01). Male sex was associated with a significantly higher risk of hepatic steatosis (OR 3.7, 95% CI 1.5-9.2). The frequency of any fibrosis as measured by LSM (≥7.0 kPa) was 3-fold higher in YOT2DM compared to people without diabetes (12% vs. 4%, p=0.08). Every 1 unit increase in BMI elevated the risk of both steatosis and fibrosis by 20% (OR 1.2, 95% CI 1.03-1.3). Conclusion: Hepatic steatosis is highly prevalent in young-onset type 2 diabetes (YOT2DM) and is strongly influenced by obesity. Hepatic fibrosis is relatively common and affects 1 in 8 people with YOT2DM. These results warrant the need for larger and longer follow-up studies in this population. Disclosure A. Sharma: None. E. Godinez Leiva: None. R. Lomonaco: None. E. Valdez Saenz: None. A. Ortiz Rocha: None. S.A. Marangi: None. M.A. Gonzalez: None. S. Shrestha: None. S.S. Shetty: None. J.T. Budd: None. D. Barb: None. S. Kalavalapalli: None. K. Cusi: Research Support; Echosens, Inventiva. Consultant; Poxel SA. Research Support; LabCorp, Zydus. Consultant; Altimmune, Arrowhead Pharmaceuticals, Inc., AstraZeneca, 89bio, Inc., Bristol-Myers Squibb Company, Lilly, Madrigal Pharmaceuticals, Inc., Merck & Co., Inc., Medscape, Myovant, Novo Nordisk, ProSciento, Quest Diagnostics, Sagimet, Sonic Incytes, Terns.