Hepatic steatosis with significant fibrosis is associated with an increased 10-year estimated risk of cardiovascular disease in adults with type 1 diabetes mellitus

Cardiovascular Diabetology

Research

Luisa Palmisano¹  Maria Masulli¹  Marco Giorgio Baroni²  Gisella Cavallo³  Flavia Agata Cimini³  Raffaella Buzzetti³  Carmen Mignogna³  Frida Leonetti⁴  Roberto Trevisan⁵  Katia Bonomo⁶  Efisio Cossu⁷  Raffaella Aldigeri⁸  Alessandra Dei Cas⁹  Saula Vigili de Kreutzenberg^1,10  Riccardo Maria Pollis^1,10  Mario Luca Morieri^1,10  Simonetta Bacci^1,11  Alessandro Mantovani^1,12  Giovanni Targher^1,13 

[1] Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy;Department of Clinical Medicine, Life, Health and Environmental Sciences, University of Aquila, L’Aquila, Italy;Neuroendocrinology and Metabolic Diseases, IRCCS Neuromed, Pozzilli, Italy;Department of Experimental Medicine, Sapienza University, Rome, Italy;Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy;Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy;Diabetes and Metabolic Diseases Unit, San Luigi Gonzaga University Hospital, Turin, Italy;Diabetology Unit, Policlinico Universitario of Cagliari, Cagliari, Italy;Division of Nutritional and Metabolic Sciences, Azienda Ospedaliero-Universitaria, Parma, Italy;Division of Nutritional and Metabolic Sciences, Azienda Ospedaliero-Universitaria, Parma, Italy;Department of Medicine and Surgery, University of Parma, Parma, Italy;Metabolic Diseases, Department of Medicine, University of Padua, Padua, Italy;Section of Endocrinology, Department of Medicine, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy;Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy;Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy;IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, VR, Italy;Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani, 1, 37126, Verona, Italy;

关键词: NAFLD;    Non-alcoholic fatty liver disease;    T1DM;    Type 1 diabetes;    CVD;    Cardiovascular disease;   

DOI  :  10.1186/s12933-023-01945-x

 received in 2023-06-26, accepted in 2023-07-28,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWe assessed whether hepatic steatosis with or without significant fibrosis (determined by validated non-invasive biomarkers) is associated with an increased 10-year estimated risk for cardiovascular disease (CVD) in people with type 1 diabetes mellitus (T1DM).MethodsWe conducted a retrospective, multicenter, cross-sectional study involving 1,254 adults with established T1DM without pre-existing CVD. We used the hepatic steatosis index (HSI) and fibrosis (FIB)-4 index for non-invasively detecting hepatic steatosis (defined as HSI > 36), with or without coexisting significant fibrosis (defined as FIB-4 index ≥ 1.3 or < 1.3). We calculated the Steno type 1 risk engine and the atherosclerotic CVD (ASCVD) risk score to estimate the 10-year risk of developing a first fatal or nonfatal CVD event.ResultsUsing the Steno type 1 risk engine, a significantly greater proportion of patients with hepatic steatosis and significant fibrosis (n = 91) had a high 10-year estimated CVD risk compared to those with hepatic steatosis alone (n = 509) or without steatosis (n = 654) (75.8% vs. 23.2% vs. 24.9%, p < 0.001). After adjustment for sex, BMI, diabetes duration, hemoglobin A1c, chronic kidney disease, and lipid-lowering medication use, patients with hepatic steatosis and significant fibrosis had an increased 10-year estimated risk of developing a first fatal or nonfatal CVD event (adjusted-odds ratio 11.4, 95% confidence interval 3.54–36.9) than those without steatosis. We observed almost identical results using the ASCVD risk calculator.ConclusionsThe 10-year estimated CVD risk is remarkably greater in T1DM adults with hepatic steatosis and significant fibrosis than in their counterparts with hepatic steatosis alone or without steatosis.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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