1995-LB: Prevalence, Risk Factors, and Clinical Characteristics of NAFLD in Individuals with Type 1 Diabetes Mellitus

Objective: Nonalcoholic fatty liver disease (NAFLD) prevalence data in age- and BMI-matched reference groups are scarce. We aimed to investigate the prevalence, risk factors, and clinical characteristics of NAFLD in individuals with type 1 diabetes mellitus (T1DM).

Methods: A retrospective study was conducted on 1,132 people with T1DM who attended the Endocrinology Department from January 2014 to December 2022. After screening, a cohort of 832 T1DM patients was included for prevalence investigation. NAFLD diagnosis was based on ultrasound findings. A 1: 2 propensity score matching based on age, sex, and duration of diabetes was performed between the NAFLD and non-NAFLD groups. Additionally, 156 age-, sex-, and BMI-matched controls with normal glucose tolerance were enrolled, with laboratory measurements recorded. The t-test, χ2 test, and nonparametric test were used for comparison between the two groups when appropriate. Multivariate logistic regression models were used to assess risk factors for NAFLD.

Results: 61 individuals of NAFLD were identified among 832 individuals with T1DM, with a lower prevalence compared to the matched controls (7.3% vs 23%, P <0.05). The NAFLD group exhibited higher BMI, glucose, triglycerides (TG), ALT, GGT, and hsCRP levels but lower HDL-C compared to the non-NAFLD group (P < 0.05). Logistic regression analysis showed that BMI (OR= 1.27, 95% CI= 1.16 - 1.51), modified HOMA-IR (OR= 1.04 [1.01,1.08]), GGT (OR= 1.03 [1.01 - 1.05]), and TG (OR= 1.55 [1.19 - 2.13]) were associated with increased risk for NAFLD after adjusting for age, sex, metabolic syndrome, and its components (P<0.001). The predictive model combining BMI, modified HOMA-IR, GGT, and triglycerides demonstrated an area under the curve of 0.823 (95% CI= 0.76 - 0.89).

Conclusion: NAFLD is less prevalent in individuals with T1DM than in matched controls. A model integrating BMI, modified HOMA-IR, GGT, and triglycerides effectively predicts NAFLD risk in this population.