Evaluation of Liver Steatosis and Liver Fibrosis in Patients with Type 1 Diabetes Mellitus Using Non-invasive Scores

Objectives: This study aimed to investigate the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and clinically significant fibrosis (CSF) in patients with type 1 diabetes mellitus (T1DM), as well as the factors affecting them, using non-invasive tests based on blood and imaging methods.
Methods: Adult T1DM patients who were followed up in the diabetes mellitus outpatient clinic at a tertiary university hospital and who did not have other causes of liver disease were prospectively investigated. MASLD and CSF were evaluated using non-invasive scores based on biochemical tests and FibroScan®. MASLD was defined as a FibroScan® CAP score ≥275 dB/m, and CSF was defined as F≥8 kPa in the absence of any other chronic liver disease or secondary cause of hepatic steatosis in T1DM patients.
Results: The prevalence of MASLD and CSF was 12.9% and 5%, respectively. BMI, fasting blood glucose, and waist and hip circumference were significantly higher in patients with MASLD (p<0.05). The rates of hypertension and dyslipidemia were also higher in patients with MASLD (p=0.026 and p=0.012, respectively). According to Pearson’s correlation test, LSM was most strongly correlated with Agile 4 (p<0.001, r=0.922) and Agile 3+ scores (p<0.001, r=0.685). CAP was most strongly correlated with the fatty liver index (p<0.001, r=0.514) and the hepatic steatosis index (p<0.001, r=0.404).
Conclusion: Components of metabolic syndrome are important risk factors for MASLD in patients with T1DM. There is currently no consensus on screening and diagnostic pathways for MASLD in T1DM, and further research is needed in this area.

Keywords: FibroScan®, metabolic dysfunction-associated steatotic liver disease, type 1 diabetes mellitus.