Prevalence and predictive features of metabolic dysfunction-associated steatotic liver disease in type 1 diabetes

European Journal of Endocrinology, vol. 190, pp. 391–400

Abstract

AIMS/HYPOTHESIS: The prevalence and severity of metabolic dysfunction-associated steatotic liver disease (MASLD) in type 1 diabetes remain unclear. Therefore, we investigated the prevalence and severity of MASLD in type 1 diabetes and assessed which clinical features are most important in predicting MASLD severity. METHODS: A total of 453 individuals with type 1 diabetes (41.6 ± 15.0 years, 64% female, body mass index [BMI] 25.4 ± 4.2 kg/m2, and HbA1c 55.6 ± 12 mmol/mol) underwent vibration-controlled transient elastography (VCTE), with a controlled attenuation parameter (CAP) score for steatosis (≥280.0 dB/m) and a liver stiffness measurement (LMS) for fibrosis (≥8.0 kPa). A machine learning Extra-Trees classification model was performed to assess the predictive power of the clinical features associated with type 1 diabetes with respect to steatosis and fibrosis. RESULTS: The prevalence of hepatic steatosis and fibrosis was 9.5% (95% CI, 6.8-12.2) and 3.5% (95% CI, 1.8-5.2). Higher LMS was associated with a longer duration of type 1 diabetes (median 30.5 [IQR 18.0-39.3] years vs 15.0 [IQR 6.0-27.0] years), and individuals were older, had a higher BMI (mean 27.8 ± 5.2 vs 25.3 ± 4.1 kg/m2), and a higher CAP score (mean 211.4 ± 51.7 dB/m vs 241.4 ± 75.6 dB/m). The most important predictive features of fibrosis were duration of type 1 diabetes, age, and systolic blood pressure, with a mean ± SD area under the curve of 0.73 ± 0.03. CONCLUSION: Individuals with type 1 diabetes and high blood pressure, older age, higher BMI, and longer duration of disease could be considered at high-risk for developing MASLD.

Authors 13

1. Coco M. Fuhri Snethlage corresponding

   Amsterdam University Medical Centers · Amsterdam Gastroenterology Endocrinology Metabolism · University of Amsterdam

   Affiliation as printed

   Department of Vascular Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam, AZ 1105 , The Netherlands

2. Abraham Stijn Meijnikman

   Amsterdam University Medical Centers · Amsterdam Gastroenterology Endocrinology Metabolism · University of Amsterdam

   Affiliation as printed

   Department of Vascular Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam, AZ 1105 , The Netherlands

3. Anne Linde Mak

   Amsterdam University Medical Centers · Amsterdam Gastroenterology Endocrinology Metabolism · University of Amsterdam

   Affiliation as printed

   Department of Vascular Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam, AZ 1105 , The Netherlands

4. Elena Rampanelli

   Amsterdam University Medical Centers · Amsterdam Gastroenterology Endocrinology Metabolism · University of Amsterdam

   Affiliation as printed

   Department of Vascular Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam, AZ 1105 , The Netherlands

5. Bas Voermans

   Amsterdam University Medical Centers · Amsterdam Gastroenterology Endocrinology Metabolism · University of Amsterdam

   Affiliation as printed

   Department of Vascular Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam, AZ 1105 , The Netherlands

   HORAIZON Technology B.V. Delft , GZ Delft 2625 , The Netherlands

6. Cengiz Callender

   Amsterdam University Medical Centers · Amsterdam Gastroenterology Endocrinology Metabolism · University of Amsterdam

   Affiliation as printed

   Department of Vascular Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam, AZ 1105 , The Netherlands

7. Pleun de Groen

   Amsterdam University Medical Centers · Amsterdam Gastroenterology Endocrinology Metabolism · University of Amsterdam

   Affiliation as printed

   Department of Vascular Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam, AZ 1105 , The Netherlands

8. Bart O Roep Aachen Internal Medicine

   Leiden University Medical Center

   Affiliation as printed

   Internal Medicine, Leids Universitair Medisch Centrum , Leiden, ZA 2333 , The Netherlands

9. Daniël H. van Raalte

   Amsterdam University Medical Centers · Amsterdam Gastroenterology Endocrinology Metabolism · Vrije Universiteit Amsterdam

   Affiliation as printed

   Department of Endocrinology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, Vrije Universiteit Amsterdam , Amsterdam, AZ 1105 , The Netherlands

10. Filip Krag Knop

    University of Copenhagen · Gentofte Hospital · Novo Nordisk Foundation Center for Basic Metabolic Research · Steno Diabetes Center Copenhagen

    Affiliation as printed

    Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen , 2900 Hellerup , Denmark

    Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , 2200 Copenhagen , Denmark

    Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen , 2200 Copenhagen , Denmark

    Steno Diabetes Center Copenhagen , Department of Clinical and Translational Research, 2730 Herlev , Denmark

11. Adriaan Georgius Holleboom

    Amsterdam University Medical Centers · Amsterdam Gastroenterology Endocrinology Metabolism · University of Amsterdam

    Affiliation as printed

    Department of Vascular Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam, AZ 1105 , The Netherlands

12. Max Nieuwdorp

    Amsterdam University Medical Centers · Amsterdam Gastroenterology Endocrinology Metabolism · University of Amsterdam

    Affiliation as printed

    Department of Vascular Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam, AZ 1105 , The Netherlands

13. Nordin M.J. Hanssen

    Amsterdam University Medical Centers · Amsterdam Gastroenterology Endocrinology Metabolism · University of Amsterdam

    Affiliation as printed

    Department of Vascular Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam, AZ 1105 , The Netherlands