TY - JOUR
T1 - Liver fat content is not elevated in people with type 1 diabetes
T2 - the Maastricht Study
AU - Dimitropoulou, Nefeli M.
AU - Beran, Magdalena
AU - Eussen, Simone J.P.M.
AU - Dingena, Cassy F.
AU - Dagnelie, Pieter C.
AU - van der Kallen, Carla J.H.
AU - Koster, Annemarie
AU - van Greevenbroek, Marleen M.J.
AU - Brouwers, Martijn C.G.J.
AU - Schram, Miranda T.
AU - de Galan, Bastiaan E.
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2025.
PY - 2026/2
Y1 - 2026/2
N2 - Aim/hypothesis: Obesity and poor dietary habits are thought to explain high liver fat content in type 2 diabetes, but they are increasingly common among individuals with type 1 diabetes. Whether people with type 1 diabetes are at an increased risk of liver fat accumulation remains unclear. We aimed to compare liver fat content in people with type 1 diabetes, with type 2 diabetes and without diabetes. Methods: Data were derived from The Maastricht Study, a population-based cohort study. We matched people with type 1 diabetes to those with type 2 diabetes and those with normal glucose metabolism (1:2:2 matching) based on BMI, sex, age and educational level. MRI was used to estimate liver fat content. Liver fat data were log-transformed. We performed multiple linear regression analyses to compare the liver fat content between the three groups, adjusted for potential confounders including CVD risk factors, lifestyle, dietary factors, insulin use and estimated glucose disposal rate (eGDR). Results: We included 29 individuals with type 1 diabetes, 58 with type 2 diabetes and 58 with normal glucose metabolism. The median liver fat content in type 1 diabetes was lower than in type 2 diabetes (2.1% [IQR 1.1–3.3] vs 4.9% [IQR 2.2–9.6], p=0.001), but did not differ from that in individuals with normal glucose metabolism (2.6% [IQR 1.8–3.8], p=0.064). The difference in liver fat content between the two diabetes groups was independent of BMI, lifestyle factors, CVD risk factors and dietary factors, but attenuated after adjustment for eGDR and insulin treatment.Conclusions/interpretation: The liver fat content of individuals with type 1 diabetes was comparable to that of people without diabetes and lower than that in those with type 2 diabetes. This difference was independent of the level of obesity, dietary factors and other potential confounders, but was partially explained by insulin sensitivity and insulin treatment.
AB - Aim/hypothesis: Obesity and poor dietary habits are thought to explain high liver fat content in type 2 diabetes, but they are increasingly common among individuals with type 1 diabetes. Whether people with type 1 diabetes are at an increased risk of liver fat accumulation remains unclear. We aimed to compare liver fat content in people with type 1 diabetes, with type 2 diabetes and without diabetes. Methods: Data were derived from The Maastricht Study, a population-based cohort study. We matched people with type 1 diabetes to those with type 2 diabetes and those with normal glucose metabolism (1:2:2 matching) based on BMI, sex, age and educational level. MRI was used to estimate liver fat content. Liver fat data were log-transformed. We performed multiple linear regression analyses to compare the liver fat content between the three groups, adjusted for potential confounders including CVD risk factors, lifestyle, dietary factors, insulin use and estimated glucose disposal rate (eGDR). Results: We included 29 individuals with type 1 diabetes, 58 with type 2 diabetes and 58 with normal glucose metabolism. The median liver fat content in type 1 diabetes was lower than in type 2 diabetes (2.1% [IQR 1.1–3.3] vs 4.9% [IQR 2.2–9.6], p=0.001), but did not differ from that in individuals with normal glucose metabolism (2.6% [IQR 1.8–3.8], p=0.064). The difference in liver fat content between the two diabetes groups was independent of BMI, lifestyle factors, CVD risk factors and dietary factors, but attenuated after adjustment for eGDR and insulin treatment.Conclusions/interpretation: The liver fat content of individuals with type 1 diabetes was comparable to that of people without diabetes and lower than that in those with type 2 diabetes. This difference was independent of the level of obesity, dietary factors and other potential confounders, but was partially explained by insulin sensitivity and insulin treatment.
UR - https://www.scopus.com/pages/publications/105021123904
U2 - 10.1007/s00125-025-06597-y
DO - 10.1007/s00125-025-06597-y
M3 - Article
C2 - 41198917
AN - SCOPUS:105021123904
SN - 0012-186X
VL - 69
SP - 364
EP - 373
JO - Diabetologia
JF - Diabetologia
IS - 2
ER -
