Hepatic steatosis and diabetic retinopathy in individuals with type 1 diabetes: a cross-sectional study using liver elastography
- 1Universidad Autónoma de Madrid. Servicio de Endocrinología y Nutrición (1). H.U. La Princesa
- 2Servicio de Endocrinología y Nutrición (2). H. U. Infanta Leonor
- 3Servicio de Endocrinologia y Nutrición (3). H. U. San Juan de Alicante
Abstract
Background: Metabolic dysfunction associated steatotic liver disease (MASLD) is increasingly recognized in individuals with type 1 diabetes (T1D). However, its relationship with diabetic retinopathy (DR) remains poorly characterized. We evaluated the association between hepatic steatosis and DR severity in adults with T1D.
Methods: We conducted a cross-sectional study including 70 adults with T1D who underwent liver elastography using FibroScan ® . Hepatic steatosis was assessed by the controlled attenuation parameter (CAP), and DR was classified according to the Early Treatment Diabetic Retinopathy Study scale. Ordinal logistic regression models were used to evaluate the association between DR stage and CAP categories.
Results: Median age was 66.5 years (IQR: 55–73), median diabetes duration was 29.0 years (IQR: 18–42), and 64.3% of participants were women. Overall, 24.3% had evidence of hepatic steatosis. In unadjusted analysis, proliferative DR was associated with higher CAP categories (OR: 6.07; 95% CI: 1.66–22.25; p = 0.006). This association remained significant after adjustment for age, sex, alcohol intake, waist circumference, diabetes duration, and HbA1c (OR: 14.12; 95% CI: 1.80–110.70; p = 0.012). Waist circumference and alcohol intake were also independently associated with higher CAP categories. The association was consistent in sensitivity analyses.
Conclusions: Proliferative DR was independently associated with greater hepatic steatosis severity assessed by CAP in adults with T1D. These findings support a potential link between hepatic involvement and advanced microvascular disease in T1D.
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BibTeX
@article{enriquez2026hepatic,
title = {{Hepatic steatosis and diabetic retinopathy in individuals with type 1 diabetes: a cross-sectional study using liver elastography}},
author = {Alicia Justel Enríquez and Elena Carrillo Lopez and Carolina Sager La Ganga and Mónica Marazuela and Fernando Sebastián-Valles},
journal = {Frontiers in Endocrinology},
year = {2026},
month = nov,
doi = {10.3389/fendo.2026.2000503},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.2000503/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Hepatic steatosis and diabetic retinopathy in individuals with type 1 diabetes: a cross-sectional study using liver elastography
AU - Alicia Justel Enríquez
AU - Elena Carrillo Lopez
AU - Carolina Sager La Ganga
AU - Mónica Marazuela
AU - Fernando Sebastián-Valles
PY - 2026
DA - 2026/11/04
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.2000503
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.2000503/full
AB - Background: Metabolic dysfunction associated steatotic liver disease (MASLD) is increasingly recognized in individuals with type 1 diabetes (T1D). However, its relationship with diabetic retinopathy (DR) remains poorly characterized. We evaluated the association between hepatic steatosis and DR severity in adults with T1D. Methods: We conducted a cross-sectional study including 70 adults with T1D who underwent liver elastography using FibroScan ® . Hepatic steatosis was assessed by the controlled attenuation parameter (CAP), and DR was classified according to the Early Treatment Diabetic Retinopathy Study scale. Ordinal logistic regression models were used to evaluate the association between DR stage and CAP categories. Results: Median age was 66.5 years (IQR: 55–73), median diabetes duration was 29.0 years (IQR: 18–42), and 64.3% of participants were women. Overall, 24.3% had evidence of hepatic steatosis. In unadjusted analysis, proliferative DR was associated with higher CAP categories (OR: 6.07; 95% CI: 1.66–22.25; p = 0.006). This association remained significant after adjustment for age, sex, alcohol intake, waist circumference, diabetes duration, and HbA1c (OR: 14.12; 95% CI: 1.80–110.70; p = 0.012). Waist circumference and alcohol intake were also independently associated with higher CAP categories. The association was consistent in sensitivity analyses. Conclusions: Proliferative DR was independently associated with greater hepatic steatosis severity assessed by CAP in adults with T1D. These findings support a potential link between hepatic involvement and advanced microvascular disease in T1D.
SN - 1664-2392
ER -