Abstract
Background The association between type 2 diabetes mellitus (T2DM) and
advanced stages of non-alcoholic fatty liver disease is well known. Some studies
indicate a relevant prevalence also in type 1 diabetes mellitus (T1DM), but so
far there is only limited data.
Objective To determine the prevalence of non-alcoholic fatty liver disease
(NAFLD)-related liver fibrosis in individuals with T1DM and compare to those
with type 2 diabetes.
Methods Diabetic patients from a single diabetes care centre were screened
for liver fibrosis by sonographic shear wave elastography (SWE). In addition,
all patients received laboratory evaluation including non-alcoholic fatty liver
fibrosis score and Fibrosis-4 Index.
Results Three hundred and forty patients were included in the study, of
these, 310 received SWE. Overall 254 patients (93 with type 1 and 161 with type
2 diabetes) had reliable measurements and were included in the final analysis.
In patients with type 1 diabetes, the prevalence of NAFLD-related liver fibrosis
was 16–21%, depending on the method of detection. Significant
liver fibrosis was observed in 30–46% of patients with type 2
diabetes.
Conclusions Our data revealed an unexpectedly high prevalence of
NAFLD-related liver fibrosis in patients with type 1 diabetes. To our knowledge,
this is one of the first studies using SWE to diagnose advanced NAFLD in type 1
diabetes in a non-preselected cohort. Considering the findings of our study,
regular screening for hepatic complications must be recommended for all diabetic
patients, even for those with type 1 diabetes.
Key words
Diabetes mellitus, type 1 - diabetes mellitus, type 2 - elasticity imaging techniques
- non-alcoholic fatty liver disease
