Metabolic dysfunction-associated steatotic liver disease (MASLD) has been linked to atherosclerotic cardiovascular disease (ASCVD), but its relationship with vascular dysfunction in type 1 diabetes mellitus (T1DM) remains under evaluation. A cross-sectional study published in Cardiovascular Diabetology assessed the correlation between MASLD and markers of arterial stiffness, subclinical atherosclerosis, and endothelial dysfunction in adults with T1DM without established ASCVD.
Non-smoking adults with T1DM underwent vascular assessments including carotid-femoral pulse wave velocity (cfPWV), carotid-intima media thickness (CIMT), flow-mediated dilation (FMD), and nitroglycerine-induced dilation (NID). MASLD was determined by ultrasound and transient elastography. Fibrosis-4 (FIB-4) was calculated as a marker of fibrosis. Participants were included in a 2:1 control-to-case ratio and matched for age and diabetes duration. Five-year ASCVD risk was assessed using the Steno Type 1 Risk Engine.
Among 105 participants, 30 had MASLD. Mean age was 51.7 ± 15.7 years, mean diabetes duration was 29.9 ± 14.3 years, 50% were male, and mean glycated hemoglobin (HbA1c) was 55.1 ± 9.5 mmol/mol (7.2 ± 0.9%). MASLD was associated with lower NID compared with those without MASLD (15.3 ± 6.3% vs 20.1 ± 7.5%; p = 0.003). Impaired NID and cfPWV were more frequent in participants 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 were age, sex, and mean arterial pressure. cfPWV (ρ = 0.76) and CIMT (ρ = 0.81) strongly correlated with 5-year ASCVD risk (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 area under the receiver operating characteristic curve values to identify significant ASCVD risk.
These findings indicate that cfPWV was the vascular marker most strongly associated with MASLD in adults with T1DM. cfPWV, CIMT, and FIB-4 showed strong correlations with estimated 5-year ASCVD risk in this cross-sectional analysis.
