Czarnik Klaudia, Sablik Zbigniew, Borkowska Anna, Drożdż Jarosław, Cypryk Katarzyna
Department of Internal Diseases and Diabetology, Medical University of Lodz, Central Teaching Hospital in Lodz, 251 Pomorska Street, 92-213, Lodz, Poland.
Department of Cardiology, Medical University of Lodz, Lodz, Poland.
Acta Diabetol. 2025 Mar;62(3):385-395. doi: 10.1007/s00592-024-02365-3. Epub 2024 Sep 17.
Diabetic cardiomyopathy in young patients with type 1 diabetes (T1D) usually presents as asymptomatic diastolic heart dysfunction with left ventricle (LV) remodeling. Its prevalence seems to be underestimated. One of the factors seemingly influencing LV remodeling is a metabolic-associated steatotic liver disease (MASLD), which was extensively investigated in patients with type 2 diabetes but not with T1D. This study aimed to describe the correlation between MASLD risk and relative wall thickness (RWT) in young patients with T1D without heart failure symptoms or treatment.
Study participants were recruited at the inpatient diabetology department, in admission order. Patients underwent a set of laboratory tests and echocardiographic examinations. The risk of MASLD was estimated using fatty liver index (FLI). Acquired data was then statistically analyzed.
The study group consisted of 55 patients. 25 participants had RWT > 0.42, suggesting LV remodeling. Study participants did not differ in HbA1c, NT-proBNP, HDL, LDL, non-HDL, and uric acid concentrations. However, patients with RWT > 0.42 had higher FLI (40.97 vs. 13.82, p < 0.01) and BMI (27.3 vs. 22.5, p < 0.01) and differed in transaminase concentrations. Moreover, patients with RWT > 0.42 had significantly higher LV mass index (85.6 vs. 68.2 g/m2) and altered mitral ring velocities. In univariable logistic regression, FLI correlated with LV remodeling risk (OR 1.028, p = 0.05). The optimal cutoff point for FLI predicting the RWT > 0.42 was 26.38 (OR 10.6, p = 0.04, sensitivity 0.857, specificity 0.657).
FLI correlates with RWT in patients with T1D independently of diabetes metabolic control and hypothetically may support recognizing T1D patients with a higher risk of LV remodeling.
1型糖尿病（T1D）年轻患者的糖尿病性心肌病通常表现为无症状的舒张性心脏功能障碍伴左心室（LV）重塑。其患病率似乎被低估了。一个似乎影响左心室重塑的因素是代谢相关脂肪性肝病（MASLD），该疾病在2型糖尿病患者中得到了广泛研究，但在1型糖尿病患者中尚未有相关研究。本研究旨在描述无心力衰竭症状或治疗的T1D年轻患者中MASLD风险与相对壁厚度（RWT）之间的相关性。
按照入院顺序在住院糖尿病科招募研究参与者。患者接受了一系列实验室检查和超声心动图检查。使用脂肪肝指数（FLI）评估MASLD风险。然后对获得的数据进行统计分析。
研究组由55名患者组成。25名参与者的RWT>0.42，提示左心室重塑。研究参与者在糖化血红蛋白、N末端脑钠肽前体（NT-proBNP）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、非高密度脂蛋白和尿酸浓度方面无差异。然而，RWT>0.42的患者FLI更高（40.97对13.82，p<0.01），体重指数（BMI）更高（27.3对22.5，p<0.01），转氨酶浓度也不同。此外，RWT>0.42的患者左心室质量指数显著更高（85.6对68.2g/m²），二尖瓣环速度改变。在单变量逻辑回归中，FLI与左心室重塑风险相关（比值比[OR]1.028，p=0.05）。FLI预测RWT>0.42的最佳截断点为26.38（OR 10.6，p=0.04，敏感性0.857，特异性0.657）。
在T1D患者中，FLI与RWT相关，独立于糖尿病代谢控制，并且理论上可能有助于识别左心室重塑风险较高的T1D患者。
