Low prevalence of non-alcoholic fatty liver disease in patients with type 1 diabetes is associated with decreased subclinical cardiovascular disease.

Background Non-alcoholic fatty liver disease (NAFLD) has been proposed as an independent cardiovascular risk factor. This study evaluated the prevalence of NAFLD in a cohort of Type 1 Diabetic (T1D) patients and its potential relationship with subclinical cardiovascular disease (CVD). Methods Cross-sectional study in which 100 T1D patients (39.4 ± 7.8 years, 54% male, all Caucasian, disease duration 21.7 ± 8.6 years, HbA1c 8.1 ± 1.0 % (64.2 ± 7.9 mmol/mol), body mass index 24.9 ± 3.2 kg/m2, 37.0% smokers, 31.0% retinopathy, 15.0% nephropathy) were included. An abdominal ultrasonography for detection of NAFLD, a carotid ultrasonography to measure carotid intima-media thickness (CIMT) and atheroma plaques and a cardiac tomography for evaluation coronary artery calcium score (CACS), were performed. Results 12% showed NAFLD and 23% displayed a CACS greater than 0. T1D subjects with NAFLD had a greater CIMT than non-NAFLD (0.65 ± 0.17 vs 0.55 ± 0.14 mm, p = 0.029), but no differences were found regarding CACS, glycemic control or presence of carotid plaques. Patients with high liver enzymes concentrations (>20 U/L) presented a greater CIMT (0.60 ± 0.16 vs 0.54 ± 0.13, p = 0.04), higher presence of altered CACS (17 (73.9%) vs 6 (26.1%), p = 0.001) and higher proportion of carotid plaques detected (10 (76.9%) vs 3 (23.1%), p = 0.014)). Conclusions A low prevalence of NAFLD was found in our T1D cohort; this was associated globally to a low proportion of abnormal CVD imaging markers, although these imaging parameters were worse in subjects in which NAFLD was detected.