Glycaemic control metrics and metabolic dysfunction–associated steatotic liver disease in children and adolescents with type 1 diabetes

Abstract Aim The aim was to examine the prevalence of metabolic dysfunction–associated steatotic liver disease (MASLD), a risk factor for atherosclerotic cardiovascular disease, and its association with glycaemic control metrics in children and adolescents with type 1 diabetes (T1D). Materials and Methods We enrolled 244 children and adolescents with T1D (115 girls, mean age: 16.2 ± 3.2 years). The diagnosis of MASLD was defined by the presence of hepatic steatosis on ultrasonography in combination with at least one of five common cardiometabolic risk factors. Metrics of short‐term and long‐term glycaemic control, blood pressure, lipids, anthropometric characteristics and three genetic variants strongly related to MASLD susceptibility (rs738409 [patatin‐like phospholipase domain‐containing 3], rs58542926 [transmembrane 6 superfamily member 2] and rs1260326 [glucokinase regulator]) were assessed. Characteristics of these subjects with and without MASLD were compared using the unpaired Student t test, Mann–Whitney test or χ 2 test as appropriate. Logistic regression analyses were performed to determine the main independent predictors of MASLD. Results The prevalence of MASLD was 27.5% in children and adolescents with T1D. Blood pressure, total cholesterol, low‐density lipoprotein (LDL) cholesterol, non‐high‐density lipoprotein cholesterol, HbA1c and time above range (TAR) were significantly higher in subjects with MASLD than in those without MASLD. Mean HbA1c values from diabetes onset (adjusted odds ratio [OR]: 1.703, 95% confidence interval [CI]: 1.040–2.787, p = 0.034), TAR (adjusted OR: 1.028, 95% CI: 1.009–1.047, p = 0.006) and plasma LDL cholesterol (adjusted OR: 1.045, 95% CI: 1.013–1.078, p = 0.004) were independently associated with the presence of MASLD. Conclusions MASLD is a common condition in children and adolescents with T1D. The mean HbA1c values from diabetes onset, TAR and LDL cholesterol levels were the independent predictors of MASLD.