Abstract：
OBJECTIVE: To compare hepatic stiffness and fat fraction in patients with obesity and type 1 diabetes (T1D) with type 2 diabetes (T2D) with a similar body mass index (BMI).
METHODS: In this prospective cross-sectional study, 90 participants with T1D (BMI 30.5 ± 4.5 kg/m2; diabetes duration 20.5 ± 9.8 years; HbA1c 8.2% ± 1.4%) and 69 with T2D (BMI: 30.8 ± 4.6 kg/m2; diabetes duration: 11.7 ± 7.8 years; HbA1c: 7.3% ± 1.4%) were included. Liver fat fraction and stiffness were examined by magnetic resonance imaging and elastography, respectively. Logistic regressions were used to evaluate associations with biomedical variables.
RESULTS: The mean liver stiffness score in patients with obesity and T1D was 2.2 ± 0.5 kPa, while in T2D it was 2.6 ± 0.8 kPa (P < .001). The liver fat fraction in patients with obesity and T1D was 3.7% ± 6.3%, and in T2D it was 10.6% ± 7.9% (P < .001). Metabolic dysfunction-associated steatotic liver disease (MASLD) was present in 13.3% of patients with T1D and in 69.6% of patients with T2D, whereas fibrosis was suggested in 7.8% of patients with T1D and in 27.5% of patients with T2D. Liver stiffness was four times higher in patients with T2D compared with those with T1D (odds ratio = 5.4, 95% confidence interval: 2.1-13.6, P < .001). Aspartate transaminase (AST), alanine transaminase, gamma-glutamyl transferase (GGT), triglycerides and the android-to-gynoid ratio were associated with elevated fat fraction in both cohorts. AST and GGT were associated with elevated liver stiffness in both cohorts.
CONCLUSIONS: Patients with obesity and T1D had lower liver fat and liver stiffness compared with those patients with T2D, despite similar levels of BMI, a longer duration of diabetes and worse glycaemic control.
METHODS: In this prospective cross-sectional study, 90 participants with T1D (BMI 30.5 ± 4.5 kg/m2; diabetes duration 20.5 ± 9.8 years; HbA1c 8.2% ± 1.4%) and 69 with T2D (BMI: 30.8 ± 4.6 kg/m2; diabetes duration: 11.7 ± 7.8 years; HbA1c: 7.3% ± 1.4%) were included. Liver fat fraction and stiffness were examined by magnetic resonance imaging and elastography, respectively. Logistic regressions were used to evaluate associations with biomedical variables.
RESULTS: The mean liver stiffness score in patients with obesity and T1D was 2.2 ± 0.5 kPa, while in T2D it was 2.6 ± 0.8 kPa (P < .001). The liver fat fraction in patients with obesity and T1D was 3.7% ± 6.3%, and in T2D it was 10.6% ± 7.9% (P < .001). Metabolic dysfunction-associated steatotic liver disease (MASLD) was present in 13.3% of patients with T1D and in 69.6% of patients with T2D, whereas fibrosis was suggested in 7.8% of patients with T1D and in 27.5% of patients with T2D. Liver stiffness was four times higher in patients with T2D compared with those with T1D (odds ratio = 5.4, 95% confidence interval: 2.1-13.6, P < .001). Aspartate transaminase (AST), alanine transaminase, gamma-glutamyl transferase (GGT), triglycerides and the android-to-gynoid ratio were associated with elevated fat fraction in both cohorts. AST and GGT were associated with elevated liver stiffness in both cohorts.
CONCLUSIONS: Patients with obesity and T1D had lower liver fat and liver stiffness compared with those patients with T2D, despite similar levels of BMI, a longer duration of diabetes and worse glycaemic control.
摘要：
目的：比较肥胖和1型糖尿病（T1D）与体重指数（BMI）相似的2型糖尿病（T2D）患者的肝硬度和脂肪分数。
方法：在这项前瞻性横断面研究中，纳入90例T1D患者（BMI30.5±4.5kg/m2；糖尿病持续时间20.5±9.8年；HbA1c8.2%±1.4%）和69例T2D患者（BMI：30.8±4.6kg/m2；糖尿病持续时间：11.7±7.8年；HbA1c：7.3%±1.4%）。通过磁共振成像和弹性成像检查肝脏脂肪分数和硬度，分别。Logistic回归用于评估与生物医学变量的关联。
结果：肥胖和T1D患者的平均肝脏硬度评分为2.2±0.5kPa，而在T2D中，为2.6±0.8kPa（P<.001）。肥胖和T1D患者的肝脏脂肪分数为3.7％±6.3％，T2D为10.6%±7.9%(P<.001)。代谢功能障碍相关的脂肪变性肝病（MASLD）存在于13.3％的T1D患者和69.6％的T2D患者中，而在7.8%的T1D患者和27.5%的T2D患者中提示纤维化。与T1D患者相比，T2D患者的肝脏硬度高四倍（比值比=5.4，95％置信区间：2.1-13.6，P<.001）。天冬氨酸转氨酶(AST),丙氨酸转氨酶，γ-谷氨酰转移酶（GGT），在两个队列中,甘油三酯和android-gynoid比值均与脂肪含量升高相关.AST和GGT与两个队列中肝脏硬度升高相关。
结论：与T2D患者相比，肥胖和T1D患者的肝脏脂肪和肝脏硬度较低，尽管BMI水平相似，糖尿病持续时间较长，血糖控制较差。
方法：在这项前瞻性横断面研究中，纳入90例T1D患者（BMI30.5±4.5kg/m2；糖尿病持续时间20.5±9.8年；HbA1c8.2%±1.4%）和69例T2D患者（BMI：30.8±4.6kg/m2；糖尿病持续时间：11.7±7.8年；HbA1c：7.3%±1.4%）。通过磁共振成像和弹性成像检查肝脏脂肪分数和硬度，分别。Logistic回归用于评估与生物医学变量的关联。
结果：肥胖和T1D患者的平均肝脏硬度评分为2.2±0.5kPa，而在T2D中，为2.6±0.8kPa（P<.001）。肥胖和T1D患者的肝脏脂肪分数为3.7％±6.3％，T2D为10.6%±7.9%(P<.001)。代谢功能障碍相关的脂肪变性肝病（MASLD）存在于13.3％的T1D患者和69.6％的T2D患者中，而在7.8%的T1D患者和27.5%的T2D患者中提示纤维化。与T1D患者相比，T2D患者的肝脏硬度高四倍（比值比=5.4，95％置信区间：2.1-13.6，P<.001）。天冬氨酸转氨酶(AST),丙氨酸转氨酶，γ-谷氨酰转移酶（GGT），在两个队列中,甘油三酯和android-gynoid比值均与脂肪含量升高相关.AST和GGT与两个队列中肝脏硬度升高相关。
结论：与T2D患者相比，肥胖和T1D患者的肝脏脂肪和肝脏硬度较低，尽管BMI水平相似，糖尿病持续时间较长，血糖控制较差。
