Minerva Endocrinologica 2020 Oct 02

DOI: 10.23736/S0391-1977.20.03290-3

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Insulin resistance and hepatic steatosis in type 1 diabetes mellitus and their association with diabetic chronic complications

Simona G. POPA ¹ ✉, Ana M. SIMION ², Mariana SOARE ², Doina ARCOMITA ³

¹ Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy Craiova, Romania; ² Department of Diabetes, Nutrition and Metabolic Diseases, Emergency Clinical Hospital Craiova, Romania; ³ Department of Internal Medicine, Emergency Clinical Hospital Sibiu, Sibiu, Romania

AIMS: To evaluate insulin resistance and hepatic steatosis and their association with diabetes duration, control and chronic complications in patients with type 1 diabetes.
METHODS: We studied medical records of 181 consecutive hospitalized adults patients with type 1 diabetes. Estimated glucose disposal rate (eGDR), insulin sensitivity score (ISS), fatty liver index (FLI) and hepatic steatosis index (HSI) were calculated.
RESULTS: Patients in the 1st tertile of eGDR (<4.1 mg/kg-1-min-1) and ISS (<4.8) had higher prevalence of ischemic cardiovascular disease (ICVD) (p<0.001), hepatic steatosis, higher gamma glutamyl transpeptidase, HSI, FLI compared with participants from the 2nd and 3rd tertile of eGDR and ISS. Compared with those without steatosis, patients with ultrasound-diagnosed steatosis (30.5%) had a higher ISS (4.4±1.9 vs 6.3±2.4, p<0.001), eGDR (4.5±3.0 vs 5.8±2.7, p=0.01), FLI (72.5±25.1 vs 51.0±27.2, p<0.001), HSI (37.5±6.1 vs 35.2±4.7, p=0.03) and prevalence of ICVD (71.7 vs 45.7%, p=0.004) and retinopathy (69.6 vs 52.4 %, p=0.03). Factors independently associated with hepatic steatosis were only ICVD (OR 0.148, p<0.001), ISS (OR=2.584, p=0.029), aspartate aminotransferase (OR=1.025, p=0.038) and male gender (OR=2.726, p=0.016).
CONCLUSIONS: Insulin resistance and hepatic steatosis are common in type 1 diabetes and have a significant association with ICVD, independently of diabetes duration, control and insulin doses.

KEY WORDS: Type 1 diabetes mellitus; Insulin resistance; Diabetes chronic complications