Elucidating the contribution of NAFLD (non-alcoholic fatty liver disease) and insulin resistance in the development of cardiovascular complications in people with type 1 diabetes.

Cardiovascular disease (CVD) is the leading cause of death in patients with type 1 diabetes (T1D). The risk of CVD is 7 times higher compared to the general population, especially in overweight and insulin resistant (IR) subjects. Nowadays, half of the T1D patients show overweight,. IR may contribute to the development of non-alcoholic fatty liver disease (NAFLD), which is characterized by liver steatosis. Importantly, CVD is the main cause of death in NAFLD. The diagnosis of NAFLD is highly dependent on liver biopsy, which is not suitable for routine screening. Non-invasive techniques are used for the diagnosis of NAFLD, but have not been validated in T1D. The exact prevalence of NAFLD and the contribution of IR have not yet been investigated in T1D. Assessing IR is difficult due to the invasive nature of the gold standard (clamp test). Since IR might play an important role in CVD and NAFLD, there is a compelling need for non-invasive diagnostics. In this multidisciplinary project, we will assess the accuracy of non-invasive tests for NAFLD, develop a screening algorithm, validate an innovative breath test to assess IR, assess the exact prevalence of NAFLD and IR in T1D, investigate the link between IR and NAFLD, and finally, assess the independent contribution of IR and NAFLD to CVD. If NAFLD contributes to CVD, its early detection and treatment may affect prognosis.

Keywords:CARDIOVASCULAR DISEASE, LIVER STEATOSIS, INSULIN RESISTANCE, DIABETES TYPE 1

Disciplines:Endocrinology, Hepatology