Al Ozairi Ebaa, Irshad Mohammad, Alkandari Jumana, Taghadom Etab, Varghese Anisha, Alroudhan Dherar, Alqattan Nasser, Gray Stuart R
DAFNE & Clinical Care Research & Trials Unit, Dasman Diabetes Institute, Kuwait City, Kuwait.
Amiri Hospital, Ministry of Health, Kuwait City, Kuwait.
Diabetes Obes Metab. 2025 Sep;27(9):5302-5310. doi: 10.1111/dom.16584. Epub 2025 Jul 14.
This study aimed to investigate the association between physical activity (PA) metrics and liver fat and stiffness in people with type 1 diabetes (T1D).
People with T1D attending clinics or participating in ongoing research at the Dasman Diabetes Institute in Kuwait were invited to participate. Liver fat fraction and stiffness were assessed using magnetic resonance imaging and elastography, respectively, liver enzymes were quantified and PA metrics were assessed over 7 days with a wrist-worn accelerometer. Associations of PA with liver fat, stiffness and enzyme biomarkers were examined using multiple linear regression.
A total of 173 participants with T1D (mean age: 40.3(14.3) years, mean body mass index (BMI): 28.8(4.8) kg/m, mean HbA1c: 7.7(1.3) %, male: 52%) were included. After adjusting for age, sex and BMI, overall PA was negatively associated with liver fat fraction (B = -0.09, p = 0.04), liver stiffness (B = -0.02, p < 0.001), AST (B = -0.23, p = 0.03) and GGT (B = -0.50, p = 0.03). The intensity gradient (B = -0.40, p = 0.01) and light PA (B = -0.001, p = 0.04) were negatively associated with liver stiffness. Moderate to vigorous physical activity (MVPA) was negatively associated with liver stiffness (B = -0.003, p = 0.001), AST (B = -0.06, p = 0.01) and GGT (B = -0.10, p = 0.02). After mutual adjustment, overall PA remained associated with liver fat (B = -0.13, p = 0.01), stiffness (B = -0.01, p = 0.01) and ALT (B = -0.38, p = 0.04), but no associations remained with the intensity gradient.
Promoting PA, particularly MVPA, in T1D may help with the maintenance of liver health.
本研究旨在调查1型糖尿病（T1D）患者的身体活动（PA）指标与肝脏脂肪及硬度之间的关联。
邀请在科威特达斯曼糖尿病研究所就诊或参与正在进行的研究的T1D患者参与。分别使用磁共振成像和弹性成像评估肝脏脂肪分数和硬度，对肝酶进行定量，并使用腕部佩戴的加速度计在7天内评估PA指标。使用多元线性回归分析PA与肝脏脂肪、硬度及酶生物标志物之间的关联。
共纳入173例T1D患者（平均年龄：40.3（14.3）岁，平均体重指数（BMI）：28.8（4.8）kg/m²，平均糖化血红蛋白（HbA1c）：7.7（1.3）%，男性：52%）。在调整年龄、性别和BMI后，总体PA与肝脏脂肪分数（B = -0.09，p = 0.04）、肝脏硬度（B = -0.02，p < 0.001）、谷草转氨酶（AST）（B = -0.23，p = 0.03）和γ-谷氨酰转肽酶（GGT）（B = -0.50，p = 0.03）呈负相关。强度梯度（B = -0.40，p = 0.01）和轻度PA（B = -0.001，p = 0.04）与肝脏硬度呈负相关。中度至剧烈身体活动（MVPA）与肝脏硬度（B = -0.003，p = 0.001）、AST（B = -0.06，p = 0.01）和GGT（B = -0.10，p = 0.02）呈负相关。相互调整后，总体PA仍与肝脏脂肪（B = -0.13，p = 0.01）、硬度（B = -0.01，p = 0.01）和谷丙转氨酶（ALT）（B = -0.38，p = 0.04）相关，但与强度梯度不再相关。
在T1D患者中促进PA，尤其是MVPA，可能有助于维持肝脏健康。
