Prevalence of nonalcoholic fatty liver disease and its association with cardiovascular disease in patients with type 1 diabetes.

Background & Aims: To estimate the prevalence of non-alcoholicfatty liver disease (NAFLD) in type 1 diabetic individuals, and toevaluate whether NAFLD is associated with increased prevalenceof cardiovascular disease (CVD).Methods: All patients with diagnosed type 1 diabetes with availableliver ultrasound data (n = 250), who regularly attended our diabetes clinic, were enrolled. Main study measures were detection of NAFLD (by patient history and liver ultrasound) andasymptomatic/symptomatic CVD (by patient history, chartreview, electrocardiogram, and echo-Doppler scanning of carotidand lower limb arteries).Results: The prevalence of NAFLD was 44.4%, and NAFLD was themost common cause (69.8%) of hepatic steatosis on ultrasoundexamination. Patients with NAFLD had a remarkably higher(p <0.001) age- and sex-adjusted prevalence of coronary (10.8%vs. 1.1%), cerebrovascular (37.3% vs. 5.5%) and peripheral (24.5% vs. 2.5%) vascular disease than their counterparts without NAFLD. In logistic regression analysis, NAFLD was associated with prevalent CVD (as composite endpoint), independently of age, sex, diabetes duration, hemoglobin A1c, smoking history, systolic blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and medication use (adjusted odds ratio 7.36, 95% confidence intervals 1.60–34.3, p <0.01).Conclusions: Our findings suggest that NAFLD is very common intype 1 diabetic subjects and is associated, independently of several confounding factors, with a higher prevalence of CVD. Future prospective studies are needed to evaluate whether NAFLD predicts incident CVD events in type 1 diabetes.