2979-LB: Clinical Utility of the FIB-4 Score in a Large Type 1 Diabetes Cohort

Introduction and Objective: The utility of FIB-4 in type 1 diabetes (T1D) is poorly described, particularly across weight strata. Methods: We analysed 974 patients with T1D. Age-adjusted cutoffs were applied. MASLD was defined as elevated FIB-4 plus ≥1 cardiometabolic risk factor. Logistic regression of highFIB-4 (≥1.3) using age, sex, BMI, HbA1c, dyslipidemia, and hypertension. Results: Elevated FIB-4 occurred in 56/540 adults (10.4%) but none in 18 years. FIB-4 score was high in 6.5% of normal weight, 11.4% in overweight, and 11.9% in obesity. FIB-4 differed across weight categories (p=0.010), but the crude distribution across weight classes was not significant (p=0.352). In adjusted analysis, age was independently associated with elevated FIB-4 (OR 1.95 per 10 years, 95% CI 1.52-2.49, p0.001), whereas BMI was not (OR 1.01 per kg/m², p=0.629). The age×weight-category interaction was not significant (p=0.372). MASLD prevalence showed a marked age gradient, the highest being in the older age group (Figure 1). Conclusion: In this large T1D cohort, FIB-4 identified a clinically relevant subgroup of adults with potential MASLD, demonstrating a strong age-dependent pattern. While overweight and obesity were associated with higher crude prevalence, age rather than BMI independently drove fibrosis risk. FIB-4 could be a pragmatic liver-risk screening in adults with T1D. However, further validation is required before routine implementation. Disclosure E. Abdelgadir: None. D. Osborne: None. J. Nafach: None. J.M. Schattenberg: Consultant; Current; 89bio, Inc., Akero Therapeutics, Inc., Alentis Therapeutics, Alexion Pharmaceuticals, Inc., Altimmune, AstraZeneca, Bionorica, Boehringer Ingelheim International GmbH, Boston Therapeutics, Inc., Eli Lilly and Company, Gilead Sciences, Inc., GlaxoSmithKline plc., HistoIndex, Ipsen Biopharmaceuticals, Inc., Inventiva Pharma, Kriya Therapeutics, Madrigal Pharmaceuticals, Inc., Merck Sharp Current; AbbVie Inc., Boehringer Ingelheim International GmbH, Gilead Sciences, Inc., Ipsen Biopharmaceuticals, Inc., Lilly, Madrigal Pharmaceuticals, Inc., Novo Nordisk. Stock/Shareholder; Current; Hepta Bio. K. Hafidh: None. B.E. Mohamad: None. A.H. Khamis: None.