Background: We 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). Methods: We 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. Results: Using 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. Conclusions: The 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.

Hepatic steatosis with significant fibrosis is associated with an increased 10-year estimated risk of cardiovascular disease in adults with type 1 diabetes mellitus / Mantovani, Alessandro; Luca Morieri, Mario; Palmisano, Luisa; Masulli, Maria; Cossu, Efisio; Baroni, Marco Giorgio; Bonomo, Katia; Cimini, FLAVIA AGATA; Cavallo, Gisella; Buzzetti, Raffaella; Mignogna, Carmen; Leonetti, Frida; Bacci, Simonetta; Trevisan, Roberto; Maria Pollis, Riccardo; Aldigeri, Raffaella; Dei Cas, Alessandra; Vigili de Kreutzenberg, Saula; Targher, Giovanni. - In: CARDIOVASCULAR DIABETOLOGY. - ISSN 1475-2840. - 22:1(2023). [10.1186/s12933-023-01945-x]

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

Marco Giorgio Baroni;Flavia Agata Cimini;Gisella Cavallo;Raffaella Buzzetti;Carmen Mignogna;Frida Leonetti;
2023

Abstract

Background: We 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). Methods: We 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. Results: Using 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. Conclusions: The 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.
2023
non-alcoholic fatty liver disease; type 1 diabetes; cardiovascular disease
01 Pubblicazione su rivista::01a Articolo in rivista
Hepatic steatosis with significant fibrosis is associated with an increased 10-year estimated risk of cardiovascular disease in adults with type 1 diabetes mellitus / Mantovani, Alessandro; Luca Morieri, Mario; Palmisano, Luisa; Masulli, Maria; Cossu, Efisio; Baroni, Marco Giorgio; Bonomo, Katia; Cimini, FLAVIA AGATA; Cavallo, Gisella; Buzzetti, Raffaella; Mignogna, Carmen; Leonetti, Frida; Bacci, Simonetta; Trevisan, Roberto; Maria Pollis, Riccardo; Aldigeri, Raffaella; Dei Cas, Alessandra; Vigili de Kreutzenberg, Saula; Targher, Giovanni. - In: CARDIOVASCULAR DIABETOLOGY. - ISSN 1475-2840. - 22:1(2023). [10.1186/s12933-023-01945-x]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1700467
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