1565-P: Relationship between Glycemic Control, Body Weight, and Nonalcoholic Fatty Liver Disease in Patients with Type 1 Diabetes

Increased body weight is a common risk factor for nonalcoholic fatty liver disease (NAFLD). Although the prevalence of overweight and obesity among patients with type 1 diabetes (T1D) is rising, most patients are still lean. Currently, little is known about the relationship between glycemic parameters, body weight and NAFLD in patients with T1D. In this study, we evaluated glycemic parameters in 200 participants with T1D (mean age 46.9±16.5 years, 55.5% females, mean diabetes duration 27.4±15.7 years, mean BMI 26.9±5.0 kg/m2) who underwent screening for NAFLD. We used transient elastography to measure controlled attenuation parameter (CAP) as an indicator of hepatic steatosis, and liver stiffness measurement (LSM) as an indicator of hepatic fibrosis. We assessed glycemic parameters by measuring A1C and collecting 3 months of continuous glucose monitoring (CGM) data. CAP score was found to be positively correlated with A1C (p=0.009) and BMI (p<0.001). Participants with NAFLD (CAP≥274 dB/m) had significantly higher A1C (p=0.025). Using CGM parameters, CAP positively correlated with average blood glucose (p=0.029) and Glucose Management Indicator (GMI) (p=0.008). CAP positively correlated with coefficient of glucose variability (CV) only in lean individuals (BMI≤25 kg/m2) (p=0.031), suggesting a link between blood glucose variability and hepatic steatosis in the absence of overweight or obesity. LSM score positively correlated with BMI (p<0.001), but not with A1C or CGM parameters. We conclude that poor glycemic control is associated with hepatic steatosis while high BMI is associated with increased risk of hepatic fibrosis in patients with T1D. Blood glucose variability is particularly associated with hepatic steatosis in lean patients with T1D. These results may suggest the need of evaluating uncontrolled patients with T1D for NAFLD, specifically those with high BMI and those with high glucose variability. Disclosure S.E.Dhaver: None. T.Salah: None. M.Al-badri: None. K.Kibaa: None. A.Khater: None. R.Mccarragher: None. F.Al-roomi: None. L.Demattos: None. O.Hamdy: Advisory Panel; Abbott Nutrition, Nemaura Medical, L-Nutra Inc., Twin Health, Consultant; Sanofi, Research Support; Novo Nordisk, Eli Lilly and Company, Gilead Sciences, Inc., Stock/Shareholder; Healthimation.