Non-Invasive Liver Scores Predict Carotid Atherosclerosis in Type 1 Diabetes, reveals research

Key Findings

• The frequency of liver steatosis and steatosis + fibrosis differed according to the scoring system.

• Based on HSI, 45.2% exhibited steatosis and 8.4% had both steatosis and fibrosis. Based on FLI, the values were 13.7% and 5.1%, respectively.

• Carotid plaque prevalence grew along the liver disease severity continuum.

• For the HSI + FIB-4, plaque prevalence was 34.6% in patients without steatosis, 38.1% with steatosis, and 64.9% with steatosis + fibrosis. With the FLI + FIB-4 combination, plaque presence increased from 38.8% to 50% to 65%, respectively, for the same groups.

• Notably, after controlling for traditional cardiovascular risk factors and T1D-specific variables, only the HSI-defined steatosis + fibrosis group had a statistically significant relationship with carotid atherosclerosis.

• The adjusted odds ratio (OR) for carotid plaque presence was 1.97 (95% CI: 1.02–3.82), and for two or more plaques, 1.97 (95% CI: 1.01–3.84).

Non-invasive liver fibrosis markers, especially when steatosis is accompanied by fibrosis, are significantly associated with increased carotid atherosclerosis in people with type 1 diabetes. These findings suggest that hepatic fibrosis scoring, using tools like HSI and FIB-4, can be integrated into cardiovascular risk assessment models to help identify high-risk T1D individuals earlier and potentially guide more intensive preventive strategies.

Reference:

Claro, M., Viñals, C., Giménez, M., Perea, V., Granados, M., Serés-Noriega, T., Blanco, J., Vinagre, I., Mesa, A., Milad, C., Ayala, D., Solà, C., Esmatjes, E., Conget, I., & Amor, A. J. (2025). Hepatic steatosis with significant fibrosis is associated with preclinical carotid atherosclerosis in patients with type 1 diabetes. Diabetes Research and Clinical Practice, 112334. https://doi.org/10.1016/j.diabres.2025.112334