Background: With increasing incidence of obesity, metabolic syndrome is not uncommon in type 1 diabetes (T1D). The association of liver dysfunction and cardiovascular disease is well established in type 2 diabetes but not in T1D. We aim to investigate associations between liver dysfunction and diabetic retinopathy and cardiac autonomic neuropathy (CAN) in adolescents with T1D.

Methods: A longitudinal study of 102 adolescents with T1D with repeated measures of liver function and CAN over 3 years. CAN was defined as 2 or more abnormal heart rate variability measures derived from a 10 minute ECG recording using Labchart Pro (mean HR; Standard deviation of mean NN intervals; root mean squared difference of successive NN intervals; low/high frequency ratio; geometric measure- Triangular index). Generalized estimating equations were used to explore associations between tertiles of liver function enzymes and cardiac autonomic neuropathy and retinopathy after adjusting for known risk factors.

Results: Baseline mean + age was 14.6 + 1.9yrs, HbA1C 8.2 + 1.4 and median duration 7.2yrs (IQR 4.8-9.6), mean BMI 23 + 4.1. Higher ALT was associated with CAN (Table1) but not retinopathy.

Conclusion: Higher ALT was associated with early CAN in youth with T1D. Inflammation might lead to higher ALT. Further studies into the potential role for obesity, liver dysfunction and CAN are required.


V. Velayutham: None. P.Z. Benitez-Aguirre: None. M.E. Craig: None. J. Cusumano: None. G. Liew: None. K.C. Donaghue: None.

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