A New Marker to Identify Liver Disease Risk in Type 1 Diabetes

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a condition where excess fat builds up in the liver, often linked to insulin resistance and metabolic problems. While it's been well-studied in people with Type 2 diabetes and the general population, less is known about how common it is in adults with Type 1 diabetes.

This new research looked at 212 adults with Type 1 diabetes to understand whether simple measurements could help identify who might have this liver condition. Finding these cases early could help doctors monitor patients more closely and recommend lifestyle changes.

The visceral adiposity index (VAI) is a calculation that combines several measurements: waist circumference, body mass index (BMI), triglycerides (a type of blood fat), and HDL cholesterol (the 'good' cholesterol). It was designed to estimate how well the body's fat tissue is functioning and whether insulin resistance is likely present.

Researchers chose to study VAI because it had shown promise in earlier research with Type 2 diabetes and general populations. However, no one had tested whether it worked the same way in people with Type 1 diabetes.

The researchers used an imaging technique called vibration-controlled transient elastography to check for liver fat and scarring in all 212 participants. They found that 62 people (29.3%) had signs of MASLD, and 9 people (4.3%) showed evidence of significant fibrosis, which is liver scarring.

Higher VAI scores were associated with increased likelihood of having MASLD. This link held true even after researchers accounted for other factors like age, how long someone had diabetes, blood sugar control, and high blood pressure.

Interestingly, when the researchers compared VAI to waist circumference alone—a much simpler measurement—they found that waist circumference actually performed better at identifying who had MASLD. This suggests that in Type 1 diabetes, a straightforward measurement around the midsection may be just as useful as a more complex calculation.

This study adds to our understanding of liver disease in people with Type 1 diabetes. While VAI showed a statistical link to MASLD, the fact that simple waist circumference worked better suggests doctors may want to focus on basic measurements already available in most clinical settings.

The finding that nearly 30% of participants had some liver involvement highlights that this is not a rare issue in the Type 1 diabetes community. More research is needed to understand whether catching and monitoring these cases early leads to better long-term health outcomes.

Source: Journal of endocrinological investigation. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.