Increased prevalence and risk of atherosclerotic cardiovascular disease in individuals with Type 1 diabetes and metabolic dysfunction-associated steatotic liver disease

Abstract Objective This study aimed to investigate the correlation between metabolic dysfunction-associated steatotic liver disease (MASLD) and atherosclerotic cardiovascular disease (ASCVD) in individuals with type 1 diabetes (T1D). Methods Adults with T1D (n = 659) were consecutively screened for...

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Main Authors: Jonathan Mertens, Jonas Weyler, Eveline Dirinck, Luisa Vonghia, Wilhelmus J. Kwanten, Luc F. Van Gaal, Benedicte Y. De Winter, Sven Francque, Christophe De Block
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Cardiovascular Diabetology
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Online Access:https://doi.org/10.1186/s12933-025-02764-y
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author Jonathan Mertens
Jonas Weyler
Eveline Dirinck
Luisa Vonghia
Wilhelmus J. Kwanten
Luc F. Van Gaal
Benedicte Y. De Winter
Sven Francque
Christophe De Block
author_facet Jonathan Mertens
Jonas Weyler
Eveline Dirinck
Luisa Vonghia
Wilhelmus J. Kwanten
Luc F. Van Gaal
Benedicte Y. De Winter
Sven Francque
Christophe De Block
author_sort Jonathan Mertens
collection DOAJ
description Abstract Objective This study aimed to investigate the correlation between metabolic dysfunction-associated steatotic liver disease (MASLD) and atherosclerotic cardiovascular disease (ASCVD) in individuals with type 1 diabetes (T1D). Methods Adults with T1D (n = 659) were consecutively screened for liver steatosis via abdominal ultrasound. The presence of macrovascular disease (including coronary artery disease [CAD], peripheral artery disease [PAD], or ischaemic stroke [CVA, cerebrovascular accident]) was identified via electronic medical records. The 5- and 10-year risks of fatal/nonfatal ASCVD were assessed via the Steno Type 1 Risk Engine. Insulin resistance was assessed via the estimated glucose disposal rate (eGDR). Results The MASLD prevalence was 16.8%. The prevalence of composite ASCVD (18.9 vs. 6.8%, p < 0.001), CAD (9.9 vs. 4.7%, p = 0.031), PAD (9.0 vs. 2.2%, p < 0.001) and CVA (6.3 vs. 1.1%, p = 0.002) was greater in people with MASLD. The 5-year (7.8 [2.1–14.4] vs. 4.8 [1.6–12.0]%, p = 0.034) and 10-year (15.0 [4.1–26.8] vs. 9.4 [3.1–22.5]%, p = 0.035) risks of ASCVD were greater in those with MASLD. MASLD was associated with prevalent ASCVD (adjusted OR 4.26, 95% CI 1.79–10.11, p < 0.001), independent of age, sex, diabetes duration, smoking, statin use, LDL-cholesterol, the glomerular filtration rate, albuminuria, and metabolic syndrome. Conclusion MASLD is associated with both an increased prevalence of ASCVD and an increased calculated risk of fatal/nonfatal ASCVD in people with T1D.
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spelling doaj-art-7a2df0e46dda489a8cfc993dcb6acb302025-08-20T01:59:57ZengBMCCardiovascular Diabetology1475-28402025-05-0124111110.1186/s12933-025-02764-yIncreased prevalence and risk of atherosclerotic cardiovascular disease in individuals with Type 1 diabetes and metabolic dysfunction-associated steatotic liver diseaseJonathan Mertens0Jonas Weyler1Eveline Dirinck2Luisa Vonghia3Wilhelmus J. Kwanten4Luc F. Van Gaal5Benedicte Y. De Winter6Sven Francque7Christophe De Block8Department of Endocrinology, Diabetology and Metabolism, Antwerp University HospitalLaboratory of Experimental Medicine and Paediatrics and member of the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of AntwerpDepartment of Endocrinology, Diabetology and Metabolism, Antwerp University HospitalLaboratory of Experimental Medicine and Paediatrics and member of the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of AntwerpLaboratory of Experimental Medicine and Paediatrics and member of the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of AntwerpDepartment of Endocrinology, Diabetology and Metabolism, Antwerp University HospitalLaboratory of Experimental Medicine and Paediatrics and member of the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of AntwerpLaboratory of Experimental Medicine and Paediatrics and member of the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of AntwerpDepartment of Endocrinology, Diabetology and Metabolism, Antwerp University HospitalAbstract Objective This study aimed to investigate the correlation between metabolic dysfunction-associated steatotic liver disease (MASLD) and atherosclerotic cardiovascular disease (ASCVD) in individuals with type 1 diabetes (T1D). Methods Adults with T1D (n = 659) were consecutively screened for liver steatosis via abdominal ultrasound. The presence of macrovascular disease (including coronary artery disease [CAD], peripheral artery disease [PAD], or ischaemic stroke [CVA, cerebrovascular accident]) was identified via electronic medical records. The 5- and 10-year risks of fatal/nonfatal ASCVD were assessed via the Steno Type 1 Risk Engine. Insulin resistance was assessed via the estimated glucose disposal rate (eGDR). Results The MASLD prevalence was 16.8%. The prevalence of composite ASCVD (18.9 vs. 6.8%, p < 0.001), CAD (9.9 vs. 4.7%, p = 0.031), PAD (9.0 vs. 2.2%, p < 0.001) and CVA (6.3 vs. 1.1%, p = 0.002) was greater in people with MASLD. The 5-year (7.8 [2.1–14.4] vs. 4.8 [1.6–12.0]%, p = 0.034) and 10-year (15.0 [4.1–26.8] vs. 9.4 [3.1–22.5]%, p = 0.035) risks of ASCVD were greater in those with MASLD. MASLD was associated with prevalent ASCVD (adjusted OR 4.26, 95% CI 1.79–10.11, p < 0.001), independent of age, sex, diabetes duration, smoking, statin use, LDL-cholesterol, the glomerular filtration rate, albuminuria, and metabolic syndrome. Conclusion MASLD is associated with both an increased prevalence of ASCVD and an increased calculated risk of fatal/nonfatal ASCVD in people with T1D.https://doi.org/10.1186/s12933-025-02764-yAtherosclerotic cardiovascular diseaseInsulin resistanceMASLDMetabolic syndromeType 1 diabetes
spellingShingle Jonathan Mertens
Jonas Weyler
Eveline Dirinck
Luisa Vonghia
Wilhelmus J. Kwanten
Luc F. Van Gaal
Benedicte Y. De Winter
Sven Francque
Christophe De Block
Increased prevalence and risk of atherosclerotic cardiovascular disease in individuals with Type 1 diabetes and metabolic dysfunction-associated steatotic liver disease
Cardiovascular Diabetology
Atherosclerotic cardiovascular disease
Insulin resistance
MASLD
Metabolic syndrome
Type 1 diabetes
title Increased prevalence and risk of atherosclerotic cardiovascular disease in individuals with Type 1 diabetes and metabolic dysfunction-associated steatotic liver disease
title_full Increased prevalence and risk of atherosclerotic cardiovascular disease in individuals with Type 1 diabetes and metabolic dysfunction-associated steatotic liver disease
title_fullStr Increased prevalence and risk of atherosclerotic cardiovascular disease in individuals with Type 1 diabetes and metabolic dysfunction-associated steatotic liver disease
title_full_unstemmed Increased prevalence and risk of atherosclerotic cardiovascular disease in individuals with Type 1 diabetes and metabolic dysfunction-associated steatotic liver disease
title_short Increased prevalence and risk of atherosclerotic cardiovascular disease in individuals with Type 1 diabetes and metabolic dysfunction-associated steatotic liver disease
title_sort increased prevalence and risk of atherosclerotic cardiovascular disease in individuals with type 1 diabetes and metabolic dysfunction associated steatotic liver disease
topic Atherosclerotic cardiovascular disease
Insulin resistance
MASLD
Metabolic syndrome
Type 1 diabetes
url https://doi.org/10.1186/s12933-025-02764-y
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