Objective: COVID-19 can affect various organs beyond the respiratory system with unclear potential long-term effects. This study aimed to assess the effect of COVID-19 infection on insulin sensitivity, lipid metabolisms and features of metabolic dysfunction-associated steatotic liver disease (MASLD) in type 2 diabetes mellitus (T2D).

Methods: Participants with T2D from the prospective German Diabetes Study (GDS) with recent history of mild (no hospital admission, O2 saturation >90%) PCR-confirmed COVID-19 (COVID+: n=14, age 58±12 years, BMI 30.9±5.2 kg/m2) were invited to a follow-up visit with comprehensive phenotyping. They were compared to GDS participants with similar baseline age- and body mass index (BMI), but without history of COVID-19 (COVID-: n=15, 61±6 years, 30.0±4.6 kg/m2). Investigations comprised clinical examination, fasting blood sampling and magnetic resonance (MR) imaging (MRI) and MR elastography (MRE). Adipose tissue volumes, hepatic lipid contents and hepatic stiffness were compared with ANCOVA, adjusted for the respective baseline values and sex, revealing whether parameters evolved differentially in COVID+ vs COVID-.

Results: COVID- and COVID+ did not differ in BMI, HOMA-IR, triglycerides-glucose index and HOMA-B, while high-density lipoprotein was lower in COVID+. Liver lipid content did not significantly change in the COVID- group (-8%, CI [-20; 15%]), but increased by 80% (CI [30; 149 %], pdifference-by-group=0.01) in the COVID+ group. Surrogate indices of liver fibrosis (FIB-4, APRI, NAFLD score, FLI, Forns index) and MRE-based hepatic stiffness were not different. Likewise, hepatic, whole body, subcutaneous and visceral adipose tissue volumes were comparable between the groups. There was no correlation between history of COVID-19 and high-sensitivity C-reactive protein (hsCRP) levels.

Conclusion: A history of COVID-19 is associated with higher hepatic lipid content long after recovery from infection.

Disclosure

I. Yurchenko: None. Y. Kupriyanova: None. P. Bobrov: None. V. Burkart: None. R. Wagner: Speaker's Bureau; Sanofi. Advisory Panel; Lilly Diabetes. Speaker's Bureau; Boehringer-Ingelheim, Novo Nordisk. V. Schrauwen-Hinderling: None. M. Roden: Advisory Panel; Eli Lilly and Company. Research Support; Boehringer-Ingelheim. Advisory Panel; Novo Nordisk. Research Support; Novo Nordisk. Advisory Panel; TARGET PharmaSolutions, Inc. Speaker's Bureau; AstraZeneca.

© 2024 by the American Diabetes Association
2024
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