Association of device measured physical activity with liver fat and stiffness in people with type 1 diabetes

This study aimed to investigate the association between physical activity (PA) metrics and liver fat and stiffness in people with type 1 diabetes (T1D).

People with T1D attending clinics or participating in ongoing research at the Dasman Diabetes Institute in Kuwait were invited to participate. Liver fat fraction and stiffness were assessed using magnetic resonance imaging and elastography, respectively, liver enzymes were quantified and PA metrics were assessed over 7 days with a wrist-worn accelerometer. Associations of PA with liver fat, stiffness and enzyme biomarkers were examined using multiple linear regression.

A total of 173 participants with T1D (mean age: 40.3(14.3) years, mean body mass index (BMI): 28.8(4.8) kg/m², mean HbA1c: 7.7(1.3) %, male: 52%) were included. After adjusting for age, sex and BMI, overall PA was negatively associated with liver fat fraction (B = -0.09, p = 0.04), liver stiffness (B = -0.02, p < 0.001), AST (B = -0.23, p = 0.03) and GGT (B = -0.50, p = 0.03). The intensity gradient (B = -0.40, p = 0.01) and light PA (B = -0.001, p = 0.04) were negatively associated with liver stiffness. Moderate to vigorous physical activity (MVPA) was negatively associated with liver stiffness (B = -0.003, p = 0.001), AST (B = -0.06, p = 0.01) and GGT (B = -0.10, p = 0.02). After mutual adjustment, overall PA remained associated with liver fat (B = -0.13, p = 0.01), stiffness (B = -0.01, p = 0.01) and ALT (B = -0.38, p = 0.04), but no associations remained with the intensity gradient.

Promoting PA, particularly MVPA, in T1D may help with the maintenance of liver health.