Prevalence and clinical determinants of non-alcoholic fatty liver disease by liver scores in adults with type 1 diabetes
To investigate the prevalence and clinical risk factors for non-alcoholic fatty liver disease (NAFLD) in type 1 diabetes (T1DM) by liver scores. A retrospective, unicenter, cross-sectional analysis was performed of adults with T1DM from 2015 to 2018. Steatosis scores (hepatic steatosis index-HSI, Fr...
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| Veröffentlicht in: | Journal of diabetes and its complications 2023-02, Vol.37 (2), p.108405-108405, Article 108405 |
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| creator | Lundholm, Michelle D. Bena, James Zhou, Keren Tsushima, Yumiko Kashyap, Sangeeta R. |
| description | To investigate the prevalence and clinical risk factors for non-alcoholic fatty liver disease (NAFLD) in type 1 diabetes (T1DM) by liver scores.
A retrospective, unicenter, cross-sectional analysis was performed of adults with T1DM from 2015 to 2018. Steatosis scores (hepatic steatosis index-HSI, Framingham steatosis index-FSI) and fibrosis scores (FIB-4 index, AST-to-platelet ratio index-APRI) were associated with clinical parameters.
We identified 447 patients, 38 ± 14.5 yrs, 54 % female, BMI 28 ± 5.9 kg/m2. Liver steatosis was prevalent at 61 % by HSI ≥ 36 and 52 % by FSI ≥ 23. A majority of these individuals had normal liver transaminase levels. The presence of advanced fibrosis was 4 % by APRI > 0.7 and 4 % by FIB-4 > 2.67. BMI ≥ 25 kg/m2 correlated with steatosis scores (P |
| doi_str_mv | 10.1016/j.jdiacomp.2023.108405 |
| format | Article |
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A retrospective, unicenter, cross-sectional analysis was performed of adults with T1DM from 2015 to 2018. Steatosis scores (hepatic steatosis index-HSI, Framingham steatosis index-FSI) and fibrosis scores (FIB-4 index, AST-to-platelet ratio index-APRI) were associated with clinical parameters.
We identified 447 patients, 38 ± 14.5 yrs, 54 % female, BMI 28 ± 5.9 kg/m2. Liver steatosis was prevalent at 61 % by HSI ≥ 36 and 52 % by FSI ≥ 23. A majority of these individuals had normal liver transaminase levels. The presence of advanced fibrosis was 4 % by APRI > 0.7 and 4 % by FIB-4 > 2.67. BMI ≥ 25 kg/m2 correlated with steatosis scores (P < 0.001) but not fibrosis scores. Older age (≥40 yrs), hypertension, dyslipidemia, and history of cardiovascular disease were associated with steatosis markers. Only 21 % had any abdominal imaging, 2 % had hepatology referral and 1 % had a liver biopsy. Glucagon-like peptide-1 agonist was prescribed in 5 % and thiazolidinedione in 4 %.
Liver scores indicating steatosis but not fibrosis is common in adults with T1DM with obesity and/or metabolic syndrome, and is associated with older age, hypertension, and dyslipidemia. NAFLD is under-diagnosed and under-investigated; a minority of patients have had any liver evaluation or treatment.
•More guidance is needed for evaluation of NASH risk in adults with type 1 diabetes.•By liver scores, steatosis but not fibrosis measures are common in type 1 diabetes.•Positive steatosis scores are associated with age and BMI, but normal transaminases.•Liver scores are a first screening step, to be followed by further evaluation.</description><identifier>ISSN: 1056-8727</identifier><identifier>EISSN: 1873-460X</identifier><identifier>DOI: 10.1016/j.jdiacomp.2023.108405</identifier><identifier>PMID: 36669324</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Age ; Aspartate Aminotransferases ; Biopsy ; Cardiovascular disease ; Cross-Sectional Studies ; Diabetes ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 1 - epidemiology ; Endocrinology ; Female ; GLP-1 receptor agonists ; Hepatitis ; Hepatology ; Humans ; Hyperlipidemia ; Hypertension ; Laboratories ; Liver cancer ; Liver Cirrhosis - complications ; Liver Cirrhosis - diagnosis ; Liver Cirrhosis - epidemiology ; Liver diseases ; Liver fibrosis ; Liver scores ; Liver steatosis ; Male ; Metabolic syndrome ; Middle Aged ; Non-alcoholic fatty liver disease ; Non-alcoholic Fatty Liver Disease - complications ; Non-alcoholic Fatty Liver Disease - diagnosis ; Non-alcoholic Fatty Liver Disease - epidemiology ; Obesity ; Overweight ; Patients ; Peptides ; Population ; Prevalence ; Retrospective Studies ; Triglycerides ; Type 1 diabetes ; Womens health ; Young Adult</subject><ispartof>Journal of diabetes and its complications, 2023-02, Vol.37 (2), p.108405-108405, Article 108405</ispartof><rights>2023</rights><rights>Copyright © 2023. Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited Feb 2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-210784bb59a200b0704031698342f473a65460b24fc70300433953ee588dedfd3</citedby><cites>FETCH-LOGICAL-c396t-210784bb59a200b0704031698342f473a65460b24fc70300433953ee588dedfd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2775946970?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993,64383,64385,64387,72239</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36669324$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lundholm, Michelle D.</creatorcontrib><creatorcontrib>Bena, James</creatorcontrib><creatorcontrib>Zhou, Keren</creatorcontrib><creatorcontrib>Tsushima, Yumiko</creatorcontrib><creatorcontrib>Kashyap, Sangeeta R.</creatorcontrib><title>Prevalence and clinical determinants of non-alcoholic fatty liver disease by liver scores in adults with type 1 diabetes</title><title>Journal of diabetes and its complications</title><addtitle>J Diabetes Complications</addtitle><description>To investigate the prevalence and clinical risk factors for non-alcoholic fatty liver disease (NAFLD) in type 1 diabetes (T1DM) by liver scores.
A retrospective, unicenter, cross-sectional analysis was performed of adults with T1DM from 2015 to 2018. Steatosis scores (hepatic steatosis index-HSI, Framingham steatosis index-FSI) and fibrosis scores (FIB-4 index, AST-to-platelet ratio index-APRI) were associated with clinical parameters.
We identified 447 patients, 38 ± 14.5 yrs, 54 % female, BMI 28 ± 5.9 kg/m2. Liver steatosis was prevalent at 61 % by HSI ≥ 36 and 52 % by FSI ≥ 23. A majority of these individuals had normal liver transaminase levels. The presence of advanced fibrosis was 4 % by APRI > 0.7 and 4 % by FIB-4 > 2.67. BMI ≥ 25 kg/m2 correlated with steatosis scores (P < 0.001) but not fibrosis scores. Older age (≥40 yrs), hypertension, dyslipidemia, and history of cardiovascular disease were associated with steatosis markers. Only 21 % had any abdominal imaging, 2 % had hepatology referral and 1 % had a liver biopsy. Glucagon-like peptide-1 agonist was prescribed in 5 % and thiazolidinedione in 4 %.
Liver scores indicating steatosis but not fibrosis is common in adults with T1DM with obesity and/or metabolic syndrome, and is associated with older age, hypertension, and dyslipidemia. NAFLD is under-diagnosed and under-investigated; a minority of patients have had any liver evaluation or treatment.
•More guidance is needed for evaluation of NASH risk in adults with type 1 diabetes.•By liver scores, steatosis but not fibrosis measures are common in type 1 diabetes.•Positive steatosis scores are associated with age and BMI, but normal transaminases.•Liver scores are a first screening step, to be followed by further evaluation.</description><subject>Adult</subject><subject>Age</subject><subject>Aspartate Aminotransferases</subject><subject>Biopsy</subject><subject>Cardiovascular disease</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 1 - epidemiology</subject><subject>Endocrinology</subject><subject>Female</subject><subject>GLP-1 receptor agonists</subject><subject>Hepatitis</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Hyperlipidemia</subject><subject>Hypertension</subject><subject>Laboratories</subject><subject>Liver cancer</subject><subject>Liver Cirrhosis - complications</subject><subject>Liver Cirrhosis - diagnosis</subject><subject>Liver Cirrhosis - epidemiology</subject><subject>Liver diseases</subject><subject>Liver fibrosis</subject><subject>Liver scores</subject><subject>Liver steatosis</subject><subject>Male</subject><subject>Metabolic syndrome</subject><subject>Middle Aged</subject><subject>Non-alcoholic fatty liver disease</subject><subject>Non-alcoholic Fatty Liver Disease - complications</subject><subject>Non-alcoholic Fatty Liver Disease - diagnosis</subject><subject>Non-alcoholic Fatty Liver Disease - epidemiology</subject><subject>Obesity</subject><subject>Overweight</subject><subject>Patients</subject><subject>Peptides</subject><subject>Population</subject><subject>Prevalence</subject><subject>Retrospective Studies</subject><subject>Triglycerides</subject><subject>Type 1 diabetes</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>1056-8727</issn><issn>1873-460X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkU1v1DAQhi1ERcvCX6gsceGSxd9JbqCqfEiV4NBKvVmOPVEdOfZiJwv77_Fquxy4cLI1et6ZsR-ErinZUkLVh2k7OW9smndbRhivxU4Q-QJd0a7ljVDk8WW9E6marmXtJXpdykQIUVLSV-iSK6V6zsQV-v0jw94EiBawiQ7b4KO3JmAHC-TZRxOXgtOIY4qNCTY9peAtHs2yHHDwe8jY-QKmAB7OhWJThoJ9xMatocZ_-eUJL4cdYFppM9TW5Q26GE0o8Pb53KCHz7f3N1-bu-9fvt18umss79XSMEraTgyD7A0jZCAtEYRT1XdcsFG03ChZHzswMdqWcEIE573kALLrHLjR8Q16f-q7y-nnCmXRsy8WQjAR0lo0a1XHmBS0q-i7f9AprTnW7SrVyl6ovs7YIHWibE6lZBj1LvvZ5IOmRB_d6Emf3eijG31yU4PXz-3XYQb3N3aWUYGPJwDqf-w9ZF2sP5pxPoNdtEv-fzP-APMlooI</recordid><startdate>202302</startdate><enddate>202302</enddate><creator>Lundholm, Michelle D.</creator><creator>Bena, James</creator><creator>Zhou, Keren</creator><creator>Tsushima, Yumiko</creator><creator>Kashyap, Sangeeta R.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>202302</creationdate><title>Prevalence and clinical determinants of non-alcoholic fatty liver disease by liver scores in adults with type 1 diabetes</title><author>Lundholm, Michelle D. ; Bena, James ; Zhou, Keren ; Tsushima, Yumiko ; Kashyap, Sangeeta R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-210784bb59a200b0704031698342f473a65460b24fc70300433953ee588dedfd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Age</topic><topic>Aspartate Aminotransferases</topic><topic>Biopsy</topic><topic>Cardiovascular disease</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 1 - epidemiology</topic><topic>Endocrinology</topic><topic>Female</topic><topic>GLP-1 receptor agonists</topic><topic>Hepatitis</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Hyperlipidemia</topic><topic>Hypertension</topic><topic>Laboratories</topic><topic>Liver cancer</topic><topic>Liver Cirrhosis - complications</topic><topic>Liver Cirrhosis - diagnosis</topic><topic>Liver Cirrhosis - epidemiology</topic><topic>Liver diseases</topic><topic>Liver fibrosis</topic><topic>Liver scores</topic><topic>Liver steatosis</topic><topic>Male</topic><topic>Metabolic syndrome</topic><topic>Middle Aged</topic><topic>Non-alcoholic fatty liver disease</topic><topic>Non-alcoholic Fatty Liver Disease - complications</topic><topic>Non-alcoholic Fatty Liver Disease - diagnosis</topic><topic>Non-alcoholic Fatty Liver Disease - epidemiology</topic><topic>Obesity</topic><topic>Overweight</topic><topic>Patients</topic><topic>Peptides</topic><topic>Population</topic><topic>Prevalence</topic><topic>Retrospective Studies</topic><topic>Triglycerides</topic><topic>Type 1 diabetes</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lundholm, Michelle D.</creatorcontrib><creatorcontrib>Bena, James</creatorcontrib><creatorcontrib>Zhou, Keren</creatorcontrib><creatorcontrib>Tsushima, Yumiko</creatorcontrib><creatorcontrib>Kashyap, Sangeeta R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>British Nursing Index</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of diabetes and its complications</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lundholm, Michelle D.</au><au>Bena, James</au><au>Zhou, Keren</au><au>Tsushima, Yumiko</au><au>Kashyap, Sangeeta R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and clinical determinants of non-alcoholic fatty liver disease by liver scores in adults with type 1 diabetes</atitle><jtitle>Journal of diabetes and its complications</jtitle><addtitle>J Diabetes Complications</addtitle><date>2023-02</date><risdate>2023</risdate><volume>37</volume><issue>2</issue><spage>108405</spage><epage>108405</epage><pages>108405-108405</pages><artnum>108405</artnum><issn>1056-8727</issn><eissn>1873-460X</eissn><abstract>To investigate the prevalence and clinical risk factors for non-alcoholic fatty liver disease (NAFLD) in type 1 diabetes (T1DM) by liver scores.
A retrospective, unicenter, cross-sectional analysis was performed of adults with T1DM from 2015 to 2018. Steatosis scores (hepatic steatosis index-HSI, Framingham steatosis index-FSI) and fibrosis scores (FIB-4 index, AST-to-platelet ratio index-APRI) were associated with clinical parameters.
We identified 447 patients, 38 ± 14.5 yrs, 54 % female, BMI 28 ± 5.9 kg/m2. Liver steatosis was prevalent at 61 % by HSI ≥ 36 and 52 % by FSI ≥ 23. A majority of these individuals had normal liver transaminase levels. The presence of advanced fibrosis was 4 % by APRI > 0.7 and 4 % by FIB-4 > 2.67. BMI ≥ 25 kg/m2 correlated with steatosis scores (P < 0.001) but not fibrosis scores. Older age (≥40 yrs), hypertension, dyslipidemia, and history of cardiovascular disease were associated with steatosis markers. Only 21 % had any abdominal imaging, 2 % had hepatology referral and 1 % had a liver biopsy. Glucagon-like peptide-1 agonist was prescribed in 5 % and thiazolidinedione in 4 %.
Liver scores indicating steatosis but not fibrosis is common in adults with T1DM with obesity and/or metabolic syndrome, and is associated with older age, hypertension, and dyslipidemia. NAFLD is under-diagnosed and under-investigated; a minority of patients have had any liver evaluation or treatment.
•More guidance is needed for evaluation of NASH risk in adults with type 1 diabetes.•By liver scores, steatosis but not fibrosis measures are common in type 1 diabetes.•Positive steatosis scores are associated with age and BMI, but normal transaminases.•Liver scores are a first screening step, to be followed by further evaluation.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36669324</pmid><doi>10.1016/j.jdiacomp.2023.108405</doi><tpages>1</tpages></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present); ProQuest Central UK/Ireland |
| subjects | Adult Age Aspartate Aminotransferases Biopsy Cardiovascular disease Cross-Sectional Studies Diabetes Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - epidemiology Endocrinology Female GLP-1 receptor agonists Hepatitis Hepatology Humans Hyperlipidemia Hypertension Laboratories Liver cancer Liver Cirrhosis - complications Liver Cirrhosis - diagnosis Liver Cirrhosis - epidemiology Liver diseases Liver fibrosis Liver scores Liver steatosis Male Metabolic syndrome Middle Aged Non-alcoholic fatty liver disease Non-alcoholic Fatty Liver Disease - complications Non-alcoholic Fatty Liver Disease - diagnosis Non-alcoholic Fatty Liver Disease - epidemiology Obesity Overweight Patients Peptides Population Prevalence Retrospective Studies Triglycerides Type 1 diabetes Womens health Young Adult |
| title | Prevalence and clinical determinants of non-alcoholic fatty liver disease by liver scores in adults with type 1 diabetes |
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