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. 2022 Jun:100:77-82.
doi: 10.1016/j.ejim.2022.03.025. Epub 2022 Apr 3.

Non-alcoholic fatty liver disease: identical etiologic factors in patients with type 1 and type 2 diabetes

Marieke de Vries  1 , Fatima El-Morabit  2 , Karel J van Erpecum  2 , Jan Westerink  3 , Simon T Bac  2 , H A H Karin Kaasjager  3 , Harold W de Valk  3
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Free article

Non-alcoholic fatty liver disease: identical etiologic factors in patients with type 1 and type 2 diabetes

Marieke de Vries et al. Eur J Intern Med. 2022 Jun.
Free article

Abstract

Aims: To compare NAFLD prevalence, distribution and its etiologic determinants in patients with type 1 diabetes (T1D) and type 2 diabetes (T2D).

Methods: In this cross-sectional study, NAFLD was evaluated by transient elastography in adult outpatients with T1D and T2D. NAFLD was defined as hepatic steatosis with or without fibrosis. Associations between insulin resistance related factors and NAFLD and advanced fibrosis (≥ F3) were explored in T1D and T2D separately, using multivariate logistic regression models. Interaction analysis was performed to compare the associations in patients with T1D and T2D.

Results: One hundred and fifty patients with T1D (mean age 47 years, male 55%, mean diabetes duration 25 years, median BMI 25 kg/m2) and 100 patients with T2D (median age 67 years, male 56%, median diabetes duration 17 years, mean BMI 30 kg/m2) were included. NAFLD prevalence was 20% in patients with T1D and 76% in patients with T2D. Advanced fibrosis prevalence was 2.0% in patients with T1D and 22% in patients with T2D. In both patients with T1D and T2D, waist circumference, BMI and metabolic syndrome were positively associated, and estimated insulin sensitivity was negatively associated with the presence of NAFLD, adjusted for age, sex and diabetes duration. There was no effect modification by diabetes type for any of these associations.

Conclusions: Despite differences in population characteristics and pathophysiology between T1D and T2D, insulin resistance related factors are similarly associated with NAFLD in both groups.

Keywords: Advanced fibrosis; Insulin resistance; NAFLD; Non-alcoholic fatty liver disease; Type 1 diabetes; Type 2 diabetes.

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