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Liver fibrosis risk: a silent threat in type 1 diabetes mellitus
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DOI：10.1007/s40618-026-03009-9.png)
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Abstract
En 中文
Metabolic dysfunction–associated steatotic liver disease (MASLD) is increasingly recognized; however, its relevance in individuals with type 1 diabetes mellitus (T1DM) remains unclear. This study aimed to investigate MASLD and its associated determinants in patients with T1DM using multiparametric liver ultrasonography and noninvasive scoring indices. This study included 43 patients with T1DM and 43 age-, gender-, and BMI-matched controls. Noninvasive steatosis and fibrosis indices were calculated. Multiparametric liver US, including liver stiffness, attenuation imaging, texture, and hepatorenal index, was used to evaluate steatosis and fibrosis. Steatosis prevalence did not differ between patients with T1DM and controls; however, both FIB-4 index and liver stiffness measurement (LSM) defined risk of liver fibrosis were significantly higher in the T1DM group (11.6% vs. 2.3%). Among patients with T1DM, those with LSM ≥ 8.0 kPa had higher FIB-4 index and hsCRP levels and more frequent retinopathy (p < 0.05). FIB-4 index demonstrated good diagnostic performance for detecting LSM-defined liver fibrosis risk (AUC = 0.86), with an optimal threshold of 0.98. hsCRP levels correlated significantly with LSM (r = 0.410, P = 0.034). We demonstrated a modest increase in liver fibrosis risk in patients with T1DM compared with controls, independent of steatosis. Lower FIB-4 cut-off values may improve sensitivity for detecting liver fibrosis in T1DM, and higher hsCRP levels in patients with LSM ≥ 8 kPa suggest an possible inflammatory contribution to fibrogenesis, supporting the clinical value of noninvasive fibrosis assessment in T1DM.
Keywords:
Type 1 diabetes mellitus
Metabolic dysfunction-associated steatotic liver disease
Liver fibrosis
FIB-4 Index
Ultrasonography
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