What does this research mean for the field?

Youth with type 1 diabetes exhibit a hepatic-sparing phenotype where hepatic fat remains low and does not drive early cardiometabolic risk, even in the presence of overweight or obesity. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to explore the link between hepatic fat content and cardiometabolic risks in adolescents with type 1 diabetes.

June 7, 2026

2105-P: Hepatic Sparing Despite Adiposity in Adolescents with Type 1 Diabetes: MRI-Based Evidence

Key Points

This research aims to explore the link between hepatic fat content and cardiometabolic risks in adolescents with type 1 diabetes.
Forty-nine adolescents with type 1 diabetes were recruited across different adiposity categories.
MRI-PDFF was used to quantify hepatic fat, while DEXA assessed total body fat.
Various cardiometabolic metrics were analyzed using Pearson correlation coefficients.
Mean hepatic fat content was 1.9±1.2% with no participants meeting the threshold for steatosis.
No association found between hepatic fat and metrics like HbA1c, LDL-C, or blood pressure.
Higher body fat percentage linked to increased LDL-C (r=0.41, p<0.001) and systolic blood pressure (r=0.33, p<0.05).

Abstract

Introduction and Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging cardiometabolic risk factor in adults with type 1 diabetes (T1D), yet its contribution to early risk in youth remains unclear. We aimed to determine the relationship between hepatic fat content, measured by MRI-proton density fat fraction (PDFF), and cardiometabolic risk markers in youth with T1D across a spectrum of adiposity. Methods: Forty-nine youth with T1D (69% male; age 16.0±2.6 years; diabetes duration 7.5±4.3 years; HbA1c 8.5±1.7%) were recruited across the adiposity spectrum (39% normal weight, 28% overweight, 33% obese). Hepatic fat content was quantified using MRI-PDFF. Total adiposity was assessed by dual-energy X-ray absorptiometry (DEXA)-derived percent body fat. Cardiometabolic outcomes included HbA1c, continuous glucose monitor (CGM)-derived time in range and coefficient of variation, LDL-C, systolic blood pressure (SBP), and carotid intima-media thickness (CIMT). Relationships were evaluated using Pearson correlation coefficients. Results: Mean hepatic fat content was low (MRI-PDFF 1.9±1.2%), and no participants met the MRI threshold for steatosis (PDFF≥5%). Hepatic fat was uniformly low and did not vary by demographic or clinical characteristics. PDFF did not differ across weight categories. Hepatic fat was not associated with HbA1c, CGM metrics, LDL-C, SBP, or CIMT. In contrast, percent body fat by DEXA was associated with higher LDL-C (r=0.41, p0.001) and SBP (r=0.33, p0.05). Conclusion: Youth with T1D exhibit a hepatic-sparing phenotype even in the presence of overweight or obesity. Our data do not suggest that hepatic fat accumulation contributes meaningfully to early cardiometabolic risk in this population. Instead, systemic adiposity, rather than hepatic steatosis, appears to be a more relevant target for cardiovascular risk assessment in youth with T1D, underscoring potential physiologic differences from adult T1D populations. Disclosure E. Tas: None. M. Gumus: None. R. Muzumdar: None. I. Libman: None. Funding UPMC Children's Hospital of Pittsburgh Foundation

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