Liver disease in people with latent autoimmune diabetes in adults (LADA): A cross-sectional study using magnetic resonance elastography

Aims: To investigate liver disease and its risk factors in LADA compared to type 1 (T1D) and type 2 (T2D) diabetes. Methods: Liver magnetic resonance (MR) and MR elastography were used to measure proton density fat fraction (PDFF) and stiffness in 31 people with LADA matched for gender, body mass index (BMI) and disease duration with 31 people with T2D, and for gender, BMI and age with 31 people with T1D. Visceral adipose tissue (VAT) was quantified by DXA. Results: Liver steatosis (PDFF >5.5%) was present in 17 (54.8%), 1 (3.2%) and 0 participants with T2D, LADA and T1D, respectively (p<0.001). Stiffness did not differ among groups. VAT was related to PDFF in the whole population, while BMI was a marker of liver fat content and of liver stiffness only in T2D (interaction p-values: <0.001 and 0.019). HbA1c and VAT associated with liver stiffness differently among diabetes types (interaction p-values: 0.034 and 0.016). Kidney function was inversely associated to liver stiffness in the whole population, without differences by diabetes type. Conclusions: Liver fat accumulates differently in LADA and in T1D compared to T2D, reflecting a different body fat distribution despite a similar BMI. Factors associated with liver stiffness differ among diabetes types.