Metabolic dysfunction-associated steatotic liver disease is associated with vascular dysfunction in type 1 diabetes.

IF 10.6 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Diabetology Pub Date : 2026-02-25 DOI:10.1186/s12933-026-03114-2

Jonathan Mertens, Tibor Stoop, Eveline Dirinck, Sven Francque, Hilde Heuten, Christophe De Block

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引用次数: 0

Abstract

Background & aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is linked to atherosclerotic cardiovascular disease (ASCVD). Markers of arterial stiffness and subclinical atherosclerosis (carotid-femoral pulse wave velocity [cfPWV], and carotid-intima media thickness [CIMT]) and endothelial dysfunction (flow-mediated dilation [FMD], nitroglycerine-induced dilation [NID]) are potential ASCVD predictors. This study examined the correlation between vasculopathy and MASLD in type 1 diabetes (T1D).

Methods: We conducted cross-sectional vascular assessments in non-smoking adults with T1D without ASCVD. MASLD was determined by ultrasound and transient elastography. FIB-4 was calculated as a marker of fibrosis. ASCVD risk scores were assessed using the Steno Type 1 Risk Engine. Subjects were included in a 2:1 control-to-case ratio and matched for age and diabetes duration.

Results: We examined 105 subjects, of whom 30 had MASLD. Mean age was 51.7 ± 15.7 years, mean diabetes duration was 29.9 ± 14.3 years. 50% were male, mean HbA1c was 55.1 ± 9.5 mmol/mol (7.2 ± 0.9%). MASLD was associated with lower NID (15.3 ± 6.3 vs. 20.1 ± 7.5%, p = 0.003). NID and cfPWV were more often impaired in people with MASLD (53.3% vs. 28.4%, p = 0.018, 56.7% vs. 35.1%, p = 0.043, respectively). In adjusted multivariable logistic regression, MASLD was associated with increased cfPWV (OR 8.30, 95% CI 1.25-55.2, p = 0.029), as was age, sex and mean arterial pressure. cfPWV and CIMT strongly correlated with 5-year ASCVD risk (cfPWV ρ = 0.76, CIMT ρ = 0.81, p < 0.001), as did FIB-4 (ρ = 0.74, p < 0.001). CIMT (0.93), cfPWV (0.88) and FIB-4 (0.88) yielded the highest AUROC to identify significant ASCVD risk.

Conclusions: cfPWV is the most robust vascular marker associated with MASLD in people with T1D. cfPWV, CIMT and FIB-4 correlated strongly to incident 5-year ASCVD risk. Sven Francque, Hilde Heuten and Christophe De Block have claimed equal senior authorship.

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代谢功能障碍相关脂肪变性肝病与1型糖尿病血管功能障碍相关

背景与目的：代谢功能障碍相关的脂肪变性肝病（MASLD）与动脉粥样硬化性心血管疾病（ASCVD）有关。动脉僵硬和亚临床动脉粥样硬化的标志物（颈动脉-股动脉脉波速度[cfPWV]和颈动脉-内膜中膜厚度[CIMT]）和内皮功能障碍（血流介导的扩张[FMD]、硝酸甘油诱导的扩张[NID]）是潜在的ASCVD预测因子。本研究探讨了1型糖尿病（T1D）患者血管病变与MASLD之间的关系。方法：我们对无ASCVD的非吸烟成年T1D患者进行了横断面血管评估。用超声和瞬态弹性图测定MASLD。计算FIB-4作为纤维化的标志物。使用Steno 1型风险引擎评估ASCVD风险评分。受试者按2:1的对照与病例比例纳入，年龄和糖尿病病程相匹配。结果：我们检查了105例受试者，其中30例患有MASLD。平均年龄51.7±15.7岁，平均糖尿病病程29.9±14.3年。50%为男性，平均HbA1c为55.1±9.5 mmol/mol（7.2±0.9%）。MASLD与较低的NID相关（15.3±6.3比20.1±7.5%,p = 0.003）。MASLD患者NID和cfPWV更常受损（分别为53.3%比28.4%,p = 0.018, 56.7%比35.1%,p = 0.043）。在调整后的多变量logistic回归中，MASLD与cfPWV升高相关（OR 8.30, 95% CI 1.25-55.2, p = 0.029），与年龄、性别和平均动脉压相关。cfPWV和CIMT与5年ASCVD风险密切相关（cfPWV ρ = 0.76, CIMT ρ = 0.81, p）结论：cfPWV是T1D患者与MASLD相关的最可靠的血管标志物。cfPWV、CIMT和FIB-4与5年ASCVD发生风险密切相关。斯文·弗朗克、希尔德·休滕和克里斯托夫·德·布洛克都声称自己是资深作者。

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来源期刊

Cardiovascular Diabetology 医学-内分泌学与代谢

CiteScore

12.30

自引率

15.10%

发文量

240

审稿时长

1 months

期刊介绍： Cardiovascular Diabetology is a journal that welcomes manuscripts exploring various aspects of the relationship between diabetes, cardiovascular health, and the metabolic syndrome. We invite submissions related to clinical studies, genetic investigations, experimental research, pharmacological studies, epidemiological analyses, and molecular biology research in this field.