Is subclinical atherosclerosis associated with visceral fat and fatty liver in adolescents with type 1 diabetes?

Introduction: There is a 3-fold higher prevalence of cardiovascular complications in patients with type 1 diabetes. The aim was to assess the relationship between subclinical atherosclerosis and visceral fat and fatty liver in diabetic adolescents. Material and methods: The study was performed on 110 adolescents with type 1 diabetes (T1D) attending the Pediatric Diabetes Clinic of the University Hospital, Ismailia, Egypt. Their mean age was 14.2 +/- 0.7 years with a mean duration of diabetes 6 +/- 0.3 years. They were divided into group 1 which consisted of 55 adolescents with T1D and normal carotid intima media thickness (cIMT) and the second group which included 55 adolescents with T1D and subclinical atherosclerosis. All adolescents were normotensive, normo-albuminuric and had no retinopathy. Visceral fat thickness was measured as the distance between the anterior wall of the aorta and the posterior surface of the rectus abdominis muscle. Hepatic steatosis was diagnosed based on enlarged liver size and evidence of diffuse hyper-echogenicity of liver relative to kidneys. Results: The mean visceral fat was significantly higher in adolescents with increased cIMT (4.8 +/- 1.6) than in the normal thickness group (3.9 +/- 1.4). Liver size was also significantly larger in the former group (13.73 +/- 2.26 versus 12.63 +/- 2.20) (p = 0.022). After adjusting for other variables, logistic regression demonstrated that glycated hemoglobin (HbA(1C)) and fatty liver are independent factors affecting cIMT, OR = 1.426 (p < 0.05) and OR = 4.71 (p < 0.05). Conclusions: In the present study, fatty liver and HbA(1C), were associated with subclinical atherosclerosis in lean adolescents with T1D.