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Liver fibrosis risk: a silent threat in type 1 diabetes mellitus

Sabri Engin Altıntop1, Tugba Barlas2, Atiye Cenay Karabork Kılıc3

  • 1Faculty of Medicine, Department of Endocrinology and Metabolism, Gazi University, Ankara, 06560, Turkey. sabrienginaltintop@gmail.com.

Journal of Endocrinological Investigation
|August 7, 2026
PubMed
Abstract

Insights

Patients with type 1 diabetes mellitus (T1DM) show increased liver fibrosis risk, independent of steatosis. Noninvasive fibrosis assessment using FIB-4 and liver stiffness measurement is clinically valuable in T1DM.

Area of Science:

  • Hepatology
  • Endocrinology
  • Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing concern.
  • The prevalence and impact of MASLD in type 1 diabetes mellitus (T1DM) patients are not well understood.

Purpose of the Study:

  • To investigate MASLD and its determinants in T1DM patients.
  • Utilize multiparametric liver ultrasonography and noninvasive scoring indices for assessment.

Main Methods:

  • Compared 43 T1DM patients with 43 matched controls.
  • Calculated noninvasive steatosis and fibrosis indices (FIB-4, LSM).
  • Employed multiparametric liver US (stiffness, attenuation, texture, hepatorenal index).

Main Results:

  • No difference in steatosis prevalence between groups.
  • Significantly higher liver fibrosis risk (FIB-4, LSM) in T1DM patients (11.6% vs. 2.3%).
  • In T1DM, higher LSM correlated with elevated FIB-4, hsCRP, and retinopathy.

Conclusions:

  • T1DM patients exhibit increased liver fibrosis risk, irrespective of steatosis.
  • Lower FIB-4 cut-offs may enhance fibrosis detection sensitivity in T1DM.
  • Elevated hsCRP in T1DM with high LSM suggests inflammation's role in fibrogenesis.
Keywords:
FIB-4 IndexLiver fibrosisMetabolic dysfunction-associated steatotic liver diseaseType 1 diabetes mellitusUltrasonography

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