title: Increased prevalence of cardiovascular disease in Type 1 diabetic patients with non-alcoholic fatty liver disease.
abstract: OBJECTIVE
  Non-alcoholic fatty liver disease (NAFLD) is associated with an increased prevalence of cardiovascular disease (CVD) in both non-diabetic and Type 2 diabetic individuals. We sought to examine whether NAFLD is associated with prevalent CVD in patients with Type 1 diabetes.
  
  
  METHODS
  We studied 343 (156 men; mean age ~45 yr) consecutive Type 1 diabetic patients with and without NAFLD, which was diagnosed by ultrasonography. The presence of CVD was diagnosed by patient history, chart review, electrocardiogram, and echo-Doppler scanning of carotid and lower limb arteries.
  
  
  RESULTS
  Compared with those without steatosis, patients with ultrasound-diagnosed NAFLD (no.=182) had a remarkably greater age- and sex-adjusted prevalence of coronary (15.4 vs 1.2%, p<0.0001), cerebrovascular (41.7 vs 9.3%, p<0.0001) and peripheral (29.7 vs 6.2%, p<0.0001) vascular disease. A multivariable logistic regression analysis revealed that NAFLD was associated with an ~8-fold higher odds of CVD (composite endpoint), independently of age, sex, body mass index, family history of CVD, smoking status, physical activity, alcohol consumption, diabetes duration, glycated hemoglobin, systolic blood pressure, plasma lipids, estimated glomerular filtration rate, albuminuria, and use of anti-hypertensive, lipid-lowering and anti-platelet medications (adjusted odds ratio 7.6, 95% confidence intervals 3.6-24.0, p<0.001).
  
  
  CONCLUSIONS
  Our results demonstrate that NAFLD is associated with an increased prevalence of asymptomatic/symptomatic CVD in patients with Type 1 diabetes, independently of several established risk factors, including the components of metabolic syndrome.
authors.affiliation: Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy. giovanni.targher@univr.it
authors.forename: G
authors.initials: G
authors.lastname: Targher
authors.forename: I
authors.initials: I
authors.lastname: Pichiri
authors.forename: G
authors.initials: G
authors.lastname: Zoppini
authors.forename: M
authors.initials: M
authors.lastname: Trombetta
authors.forename: E
authors.initials: E
authors.lastname: Bonora
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D048909:Diabetes Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D005234:Fatty Liver / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D015995:Prevalence; D012307:Risk Factors