Endocrine Abstracts

Introduction: The risk of cardiovascular disease (CVD) is increased in type 1 diabetes (T1D). Metabolic dysfunction-associated steatotic liver disease (MASLD) is linked to CVD, but evidence hereof is limited in people with T1D. Endothelial dysfunction is currently considered a key early event in the atherosclerotic process, but is never determined in people with T1D and co-existent MASLD.

Methods: We measured flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD) in non-smoking adults without prior CVD with T1D. MASLD was diagnosed using ultrasound and presence of minimally one cardiometabolic risk factor. FMD was evaluated by longitudinal ultrasonographic imaging of the right brachial artery at rest and during reactive hyperaemia after inflating and deflating a forearm blood pressure cuff distal to the ultrasound probe (200 mmHg or ≥50 mm Hg above peak systolic blood pressure for 5 minutes) using high-resolution B-mode ultrasound. Wall-tracking software and continuous ECG registration were used to measure the end-diastolic diameter, coincident with the R-wave. Following FMD, NMD was evaluated by administering 25 µg of nitro-glycerine.

Results: Ninety-two adults were included, of whom 23 had MASLD. Diabetes duration was 30±14 years, median HbA1c was 7.0% (IQR 6.6-7.6). People with MASLD had a higher BMI compared to those without (31.6 [29.0-34.0] (MASLD) vs 23.9 [22.5-26.7]kg/m² (no MASLD), P<0.001). There were no differences in age, diabetes duration, blood pressure, presence of arterial hypertension, kidney function, or low-density lipoprotein cholesterol between groups. Cohort FMD was 5.47±2.89%, while NMD measured 19.7±7.1%. There was no significant difference in FMD between groups (5.58±3.12 (MASLD) vs 5.43±2.83% (non MASLD), P=0.836), but NMD was lower in those with MASLD (16.8±5.0 (MASLD) vs 20.8±7.5% (non MASLD), P=0.009).

Conclusion: Endothelial-independent vasodilation (NMD) is compromised in people with T1D and co-existent MASLD. However we could not notice a difference in endothelial-dependent dilation (FMD) between groups.