title: Prevalence of non-alcoholic fatty liver disease and its association with cardiovascular disease in patients with type 1 diabetes.
abstract: OBJECTIVE
  To estimate the prevalence of non-alcoholic fatty liver disease (NAFLD) in type 1 diabetic individuals, and to evaluate whether NAFLD is associated with increased prevalence of cardiovascular disease (CVD).
  
  
  METHODS
  All patients with diagnosed type 1 diabetes with available liver ultrasound data (n=250), who regularly attended our diabetes clinic, were enrolled. Main study measures were detection of NAFLD (by patient history and liver ultrasound) and asymptomatic/symptomatic CVD (by patient history, chart review, electrocardiogram, and echo-Doppler scanning of carotid and lower limb arteries).
  
  
  RESULTS
  The prevalence of NAFLD was 44.4%, and NAFLD was the most common cause (69.8%) of hepatic steatosis on ultrasound examination. Patients with NAFLD had a remarkably higher (p<0.001) age- and sex-adjusted prevalence of coronary (10.8% vs. 1.1%), cerebrovascular (37.3% vs. 5.5%) and peripheral (24.5% vs. 2.5%) vascular disease than their counterparts without NAFLD. In logistic regression analysis, NAFLD was associated with prevalent CVD (as composite endpoint), independently of age, sex, diabetes duration, hemoglobin A(1c), smoking history, systolic blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and medication use (adjusted odds ratio 7.36, 95% confidence intervals 1.60-34.3, p<0.01).
  
  
  CONCLUSIONS
  Our findings suggest that NAFLD is very common in type 1 diabetic subjects and is associated, independently of several confounding factors, with a higher prevalence of CVD. Future prospective studies are needed to evaluate whether NAFLD predicts incident CVD events in type 1 diabetes.
authors.affiliation: Section of Endocrinology, Department of Biomedical and Surgical Sciences, University of Verona, Verona, Italy. giovanni.targher@univr.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Targher
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bertolini
authors.forename: Roberto
authors.initials: R
authors.lastname: Padovani
authors.forename: Stefano
authors.initials: S
authors.lastname: Rodella
authors.forename: Giacomo
authors.initials: G
authors.lastname: Zoppini
authors.forename: Isabella
authors.initials: I
authors.lastname: Pichiri
authors.forename: Claudia
authors.initials: C
authors.lastname: Sorgato
authors.forename: Luciano
authors.initials: L
authors.lastname: Zenari
authors.forename: Enzo
authors.initials: E
authors.lastname: Bonora
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000453:epidemiology*; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D015995:Prevalence; D014463:Ultrasonography