OR24-01 Characteristics Of Patients With Type 1 Or 2 Diabetes And Non-alcoholic Fatty Liver Disease: A Retrospective Cohort Study
Authors: Liu Anna , Brar Sukhman , McKenzie Kate , Beaton Melanie , Lapier Heather , Hramiak Irene , Brahmania Mayur , Spaic Tamara , Clemens Kristin K 
Published: October 2023

Disclosure: A. Liu: None. S. Brar: None. K. McKenzie: None. M. Beaton: Advisory Board Member; Self; Abbvie, Takeda, Janssen Research & Development Company, Pfizer, Inc., Novo Nordisk. Research Investigator; Self; Abbvie, Novo Nordisk, Takeda, Boehringer Ingelheim, Janssen Research & Development Company, Pfizer, Inc., AstraZeneca. H. Lapier: None. I. Hramiak: None. M. Brahmania: None. T. Spaic: Advisory Board Member; Self; Sanofi. Research Investigator; Self; Novo Nordisk, Lilly USA, LLC. Speaker; Self; Sanofi. K.K. Clemens: None.

Background: Non-alcoholic fatty liver disease (NAFLD) ranges from steatosis to non-alcoholic steatohepatitis (NASH) cirrhosis, which is the second leading cause of liver transplant in the United States. Though the association between T2D and NAFLD is well-known, there is a paucity of data on patients with T1D who live with this condition. We aimed to describe the characteristics of adult patients with NAFLD and T1D. Methods: We conducted a retrospective cohort study of patients 18 years old at a single academic center with gastroenterologist diagnosed NAFLD and T1D between 2010 and 2022. As a comparator, we also included adults with T2D and NAFLD. We used descriptive statistics to summarize their characteristics and compared data between groups. Results: There were 11 patients with T1D and NAFLD (54% female, mean age 37±12 years) and 166 with T2D and NAFLD (57% female, mean age 64±11 years). Mean diabetes duration before NAFLD diagnosis was 16.6±13 years in T1D and 16.6 ±8 years in T2D patients. The most common comorbidities were dyslipidemia (T1D=73%, T2D=79%) and hypertension (T1D=55%, T2D=78%). None with T1D had macrovascular complications. In those with T2D, 36 (22%) had macrovascular complications. Microvascular complications were present in 6 (55%) with T1D and in 83 (50%) T2D patients. At the time of their NAFLD diagnosis, mean BMI of those with T1D was 31.7±5.8 kg/m2 vs 35.8±10 kg/m2 in T2D patients. Mean HbA1c was 9.1±1.7% vs 7±1.2% in T1D and T2D patients respectively. In patients with T1D vs T2D, respective mean triglycerides were 3.7±4.7 vs 2±1.0 (&lt;/=1.7) mmol/L, LDL 2.6±0.9 vs 2±0.9 (&lt;/=2.0) mmol/L, and HDL 1.1±0.4 vs 1.2±0.4 (&lt;/=1.3) mmol/L. In patients with T1D and T2D, liver enzymes were on average elevated with respective ALT 49.5±58.1 and 46.3±40.2 (&lt;/=33) U/L, AST 42.3±49.4 SD and 41.6±28.8 (&lt;/=32) U/L, ALP 115.1±39.9 and 92.9±42.3 (35-104) U/L. One patient with T1D (9%) and 78 (47%) patients with T2D developed cirrhosis. Conclusion: Patients with T1D and T2D with NAFLD appeared to develop disease at similar diabetes duration. Relative to those with T2D, patients with T1D had suboptimal glycemic control. Patients with T1D and T2D demonstrated metabolic syndrome with obesity, high triglycerides and low HDL. None of the patients with T1D had macrovascular complications, however microvascular complications were present in approximately half of patients with T1D and T2D. We have demonstrated that NAFLD is present in patients with T1D who may have features of metabolic syndrome and suboptimal glycemic control. Further studies are needed to explore the characteristics of patients with T1D who are at risk of developing NAFLD.

Presentation: Saturday, June 17, 2023