Metabolic dysfunction-associated steatotic liver disease is associated with vascular dysfunction in type 1 diabetes.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is linked to atherosclerotic cardiovascular disease (ASCVD). Markers of arterial stiffness and subclinical atherosclerosis (carotid-femoral pulse wave velocity [cfPWV], and carotid-intima media thickness [CIMT]) and endothelial dysfunction (flow-mediated dilation [FMD], nitroglycerine-induced dilation [NID]) are potential ASCVD predictors. This study examined the correlation between vasculopathy and MASLD in type 1 diabetes (T1D).
We conducted cross-sectional vascular assessments in non-smoking adults with T1D without ASCVD. MASLD was determined by ultrasound and transient elastography. FIB-4 was calculated as a marker of fibrosis. ASCVD risk scores were assessed using the Steno Type 1 Risk Engine. Subjects were included in a 2:1 control-to-case ratio and matched for age and diabetes duration.
We examined 105 subjects, of whom 30 had MASLD. Mean age was 51.7 ± 15.7 years, mean diabetes duration was 29.9 ± 14.3 years. 50% were male, mean HbA1c was 55.1 ± 9.5 mmol/mol (7.2 ± 0.9%). MASLD was associated with lower NID (15.3 ± 6.3 vs. 20.1 ± 7.5%, p = 0.003). NID and cfPWV were more often impaired in people with MASLD (53.3% vs. 28.4%, p = 0.018, 56.7% vs. 35.1%, p = 0.043, respectively). In adjusted multivariable logistic regression, MASLD was associated with increased cfPWV (OR 8.30, 95% CI 1.25-55.2, p = 0.029), as was age, sex and mean arterial pressure. cfPWV and CIMT strongly correlated with 5-year ASCVD risk (cfPWV ρ = 0.76, CIMT ρ = 0.81, p < 0.001), as did FIB-4 (ρ = 0.74, p < 0.001). CIMT (0.93), cfPWV (0.88) and FIB-4 (0.88) yielded the highest AUROC to identify significant ASCVD risk.
cfPWV is the most robust vascular marker associated with MASLD in people with T1D. cfPWV, CIMT and FIB-4 correlated strongly to incident 5-year ASCVD risk. Sven Francque, Hilde Heuten and Christophe De Block have claimed equal senior authorship.
We conducted cross-sectional vascular assessments in non-smoking adults with T1D without ASCVD. MASLD was determined by ultrasound and transient elastography. FIB-4 was calculated as a marker of fibrosis. ASCVD risk scores were assessed using the Steno Type 1 Risk Engine. Subjects were included in a 2:1 control-to-case ratio and matched for age and diabetes duration.
We examined 105 subjects, of whom 30 had MASLD. Mean age was 51.7 ± 15.7 years, mean diabetes duration was 29.9 ± 14.3 years. 50% were male, mean HbA1c was 55.1 ± 9.5 mmol/mol (7.2 ± 0.9%). MASLD was associated with lower NID (15.3 ± 6.3 vs. 20.1 ± 7.5%, p = 0.003). NID and cfPWV were more often impaired in people with MASLD (53.3% vs. 28.4%, p = 0.018, 56.7% vs. 35.1%, p = 0.043, respectively). In adjusted multivariable logistic regression, MASLD was associated with increased cfPWV (OR 8.30, 95% CI 1.25-55.2, p = 0.029), as was age, sex and mean arterial pressure. cfPWV and CIMT strongly correlated with 5-year ASCVD risk (cfPWV ρ = 0.76, CIMT ρ = 0.81, p < 0.001), as did FIB-4 (ρ = 0.74, p < 0.001). CIMT (0.93), cfPWV (0.88) and FIB-4 (0.88) yielded the highest AUROC to identify significant ASCVD risk.
cfPWV is the most robust vascular marker associated with MASLD in people with T1D. cfPWV, CIMT and FIB-4 correlated strongly to incident 5-year ASCVD risk. Sven Francque, Hilde Heuten and Christophe De Block have claimed equal senior authorship.
Authors
Mertens Mertens, Stoop Stoop, Dirinck Dirinck, Francque Francque, Heuten Heuten, De Block De Block
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