Glycaemic control metrics and metabolic dysfunction–associated steatotic liver disease in children and adolescents with type 1 diabetes

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes, Obesity & Metabolism Pub Date : 2024-09-30 DOI:10.1111/dom.15961

Claudio Maffeis MD, Claudia Piona MD, Anita Morandi MD, Marco Marigliano MD, Elisa Morotti MD, Valentina Mancioppi MD, Erika Caiazza MD, Chiara Zusi PhD, Federica Emiliani BSc, Alessandro Mantovani MD, Antonio Colecchia MD, Giovanni Targher MD

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Abstract

Aim

The aim was to examine the prevalence of metabolic dysfunction–associated steatotic liver disease (MASLD), a risk factor for atherosclerotic cardiovascular disease, and its association with glycaemic control metrics in children and adolescents with type 1 diabetes (T1D).

Materials and Methods

We enrolled 244 children and adolescents with T1D (115 girls, mean age: 16.2 ± 3.2 years). The diagnosis of MASLD was defined by the presence of hepatic steatosis on ultrasonography in combination with at least one of five common cardiometabolic risk factors. Metrics of short-term and long-term glycaemic control, blood pressure, lipids, anthropometric characteristics and three genetic variants strongly related to MASLD susceptibility (rs738409 [patatin-like phospholipase domain-containing 3], rs58542926 [transmembrane 6 superfamily member 2] and rs1260326 [glucokinase regulator]) were assessed. Characteristics of these subjects with and without MASLD were compared using the unpaired Student t test, Mann–Whitney test or χ² test as appropriate. Logistic regression analyses were performed to determine the main independent predictors of MASLD.

Results

The prevalence of MASLD was 27.5% in children and adolescents with T1D. Blood pressure, total cholesterol, low-density lipoprotein (LDL) cholesterol, non-high-density lipoprotein cholesterol, HbA1c and time above range (TAR) were significantly higher in subjects with MASLD than in those without MASLD. Mean HbA1c values from diabetes onset (adjusted odds ratio [OR]: 1.703, 95% confidence interval [CI]: 1.040–2.787, p = 0.034), TAR (adjusted OR: 1.028, 95% CI: 1.009–1.047, p = 0.006) and plasma LDL cholesterol (adjusted OR: 1.045, 95% CI: 1.013–1.078, p = 0.004) were independently associated with the presence of MASLD.

Conclusions

MASLD is a common condition in children and adolescents with T1D. The mean HbA1c values from diabetes onset, TAR and LDL cholesterol levels were the independent predictors of MASLD.

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1 型糖尿病儿童和青少年的血糖控制指标与代谢功能障碍相关的脂肪肝。

目的：研究 1 型糖尿病（T1D）儿童和青少年代谢功能障碍相关性脂肪肝（MASLD）的发病率（MASLD 是动脉粥样硬化性心血管疾病的危险因素）及其与血糖控制指标的关系：我们招募了 244 名 1 型糖尿病儿童和青少年（115 名女孩，平均年龄：16.2 ± 3.2 岁）。MASLD的诊断标准是在超声波检查中发现肝脏脂肪变性，并同时存在五种常见的心脏代谢风险因素中的至少一种。研究人员评估了短期和长期血糖控制指标、血压、血脂、人体测量特征以及与 MASLD 易感性密切相关的三个基因变异（rs738409 [patatin-like phospholipase domain-containing 3]、rs58542926 [transmembrane 6 superfamily member 2] 和 rs1260326 [glucokinase regulator]）。采用非配对学生 t 检验、Mann-Whitney 检验或 χ2 检验（视情况而定）比较这些患有和未患有 MASLD 的受试者的特征。进行逻辑回归分析以确定 MASLD 的主要独立预测因素：结果：在患有 T1D 的儿童和青少年中，MASLD 的患病率为 27.5%。MASLD患者的血压、总胆固醇、低密度脂蛋白（LDL）胆固醇、非高密度脂蛋白胆固醇、HbA1c和超出范围时间（TAR）均显著高于非MASLD患者。从糖尿病发病开始的平均 HbA1c 值（调整后的几率比 [OR]：1.703，95% 置信区间 [CI]：1.040-2.787，p = 0.034）、TAR（调整后 OR：1.028，95% CI：1.009-1.047，p = 0.006）和血浆低密度脂蛋白胆固醇（调整后 OR：1.045，95% CI：1.013-1.078，p = 0.004）与 MASLD 的存在独立相关：结论：MASLD是患有T1D的儿童和青少年中的一种常见病。结论：MASLD 是 T1D 儿童和青少年患者中的常见病，糖尿病发病时的平均 HbA1c 值、TAR 和低密度脂蛋白胆固醇水平是 MASLD 的独立预测因素。

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来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.