PMID- 36602856
OWN - NLM
STAT- MEDLINE
DCOM- 20230525
LR  - 20240305
IS  - 1897-9483 (Electronic)
IS  - 0032-3772 (Linking)
VI  - 133
IP  - 5
DP  - 2023 May 23
TI  - Indirect insulin resistance markers are associated with nonalcoholic fatty liver 
      disease in type 1 diabetes.
LID - 16404 [pii]
LID - 10.20452/pamw.16404 [doi]
AB  - INTRODUCTION: Insulin resistance (IR) in type 1 diabetes mellitus (T1DM) is 
      associated with increased insulin dose requirements, poor glycemic control, and 
      elevated risk of chronic complications. IR increases lipid synthesis and hepatic 
      lipid content. Disruption in hepatic lipid accumulation and export leads to liver 
      steatosis resulting in nonalcoholic liver disease (NAFLD). OBJECTIVES: The aim of 
      the study was to explore the relationship between indirect IR markers and NAFLD 
      in T1DM. PATIENTS AND METHODS: We analyzed 151 patients with T1DM (59 men, 92 
      women), with a median (interquartile range [IQR]) age of 40 (33-47) years and a 
      median (IQR) diabetes duration of 19 (13-21)years. The median (IQR) value of 
      glycated hemoglobin (HbA1c) was 7.5% (6.8%-8.%; 58 [51-66] mmol/mol). The 
      following indirect IR markers were evaluated: estimated glucose distribution rate 
      (eGDR), visceral adiposity index (VAI), and the triglyceride to high‑density 
      lipoprotein cholesterol ratio (TG/HDL‑C). Fatty infiltration of the liver was 
      quantified using transient elastography. Presence of NAFLD was defined as a 
      controlled attenuation parameter value of 238 dB/m or greater. RESULTS: NAFLD was 
      observed in 65 patients (43%). The participants with NAFLD were less 
      insulin‑sensitive (eGDR, 8.93 [6.39-9.97] vs 9.94 [8.09-11.13] mg/kg/min; P = 
      0.001; VAI, 1.52 [1.2-2.64] vs 1.34 [0.92-1.74]; P = 0.014; TG/HDL‑C ratio, 1.35 
      [0.95-2.11] vs 1.11 [0.77-1.6]; P = 0.02) and were characterized by higher HbA1c 
      values (7.75% [7.2%-8.4%] vs 7.3% [6.5%-8.1%]; 61 [55-68] vs 56 [48-65] mmol/mol; 
      P = 0.02) than the patients without the disease. In a multivariable regression 
      analysis adjusted for sex, diabetes duration, and HbA1c level, indirect IR 
      markers were independently associated with NAFLD (eGDR: odds ratio [OR], 0.86; 
      95% CI, 0.77-0.97; P = 0.01; VAI: OR, 1.61; 95% CI, 1.05-2.49; P = 0.03, TG/HDL‑C 
      ratio: OR, 1.88; 95% CI, 1.11-3.18; P = 0.02). CONCLUSIONS: In T1DM, NAFLD is 
      more likely to be found in individuals with lower insulin sensitivity.
FAU - Grzelka-Wozniak, Agata
AU  - Grzelka-Wozniak A
AD  - Department of Internal Medicine and Diabetology, Poznan University of Medical 
      Sciences, Poznan, Poland. agrzelka@ump.edu.pl
FAU - Uruska, Aleksandra
AU  - Uruska A
AD  - Department of Internal Medicine and Diabetology, Poznan University of Medical 
      Sciences, Poznan, Poland
FAU - Szymanska-Garbacz, Elektra
AU  - Szymanska-Garbacz E
AD  - Department of Internal Medicine and Nephrodiabetology, Medical University of 
      Lodz, Lodz, Poland
FAU - Araszkiewicz, Aleksandra
AU  - Araszkiewicz A
AD  - Department of Internal Medicine and Diabetology, Poznan University of Medical 
      Sciences, Poznan, Poland
FAU - Jablkowski, Maciej
AU  - Jablkowski M
AD  - Department of Infectious and Liver Diseases, Medical University of Lodz, Lodz, 
      Poland
FAU - Czupryniak, Leszek
AU  - Czupryniak L
AD  - Department of Diabetology and Internal Medicine, Medical University of Warsaw, 
      Warsaw, Poland
FAU - Zozulinska-Ziolkiewicz, Dorota
AU  - Zozulinska-Ziolkiewicz D
AD  - Department of Internal Medicine and Diabetology, Poznan University of Medical 
      Sciences, Poznan, Poland
LA  - eng
PT  - Journal Article
DEP - 20230105
PL  - Poland
TA  - Pol Arch Intern Med
JT  - Polish archives of internal medicine
JID - 101700960
RN  - 0 (Glycated Hemoglobin)
RN  - 0 (Insulin)
RN  - 0 (Triglycerides)
RN  - 0 (Cholesterol, HDL)
SB  - IM
CIN - Pol Arch Intern Med. 2023 May 23;133(5):. PMID: 37219468
CIN - Pol Arch Intern Med. 2023 Aug 30;133(7-8):. PMID: 37646595
CIN - Pol Arch Intern Med. 2024 Jan 29;134(1):. PMID: 38284869
CIN - Pol Arch Intern Med. 2024 Jan 29;134(1):. PMID: 38284874
MH  - Male
MH  - Humans
MH  - Female
MH  - Adult
MH  - Middle Aged
MH  - *Non-alcoholic Fatty Liver Disease/complications
MH  - *Diabetes Mellitus, Type 1/complications
MH  - *Insulin Resistance
MH  - Glycated Hemoglobin
MH  - Insulin
MH  - Triglycerides
MH  - Cholesterol, HDL
EDAT- 2023/01/06 06:00
MHDA- 2023/05/25 06:42
CRDT- 2023/01/05 11:55
PHST- 2023/05/25 06:42 [medline]
PHST- 2023/01/06 06:00 [pubmed]
PHST- 2023/01/05 11:55 [entrez]
AID - 16404 [pii]
AID - 10.20452/pamw.16404 [doi]
PST - ppublish
SO  - Pol Arch Intern Med. 2023 May 23;133(5):16404. doi: 10.20452/pamw.16404. Epub 
      2023 Jan 5.