1625-P: High Liver Stiffness Is Prevalent But Not Associated with Steatosis in Autoimmune Diabetes—A MRI Study Comparing BMI-Matched Adults with T1D, LADA, or T2D

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Introduction and Objective: Liver steatosis (Ste) and augmented stiffness (AStif) are more common in T2D than in T1D. We investigated liver disease and risk factors in LADA compared to T1D and T2D. Methods: Liver MRI with elastography was performed in 31 people with LADA, 21 with T1D and 28 with T2D matched for BMI (Table). Ste was defined for fat fraction >5.5% and AStif for stiffness ≥2.5 KPa. Visceral adipose tissue (VAT) was evaluated by DXA. C-peptide, adiponectin and leptin levels were measured. Results: Ste and AStif were less common in LADA than in T2D (3.2% vs 60.7%, p<0.001; 22.6% vs 46.4%, p<0.05, respectively). No differences were found between T1D and LADA. LADA had lower VAT (median [IQR]: 293 [135]g vs 570 [338]g, p<0.001) and higher adiponectin/leptin ratio (1.2 [3.5] vs 0.5 [0.9], p=0.028) than T2D. Ste was observed in 83% T2D people with AStif, but in no LADA or T1D people with AStif (p<0.001). Liver stiffness was associated with HbA1c in LADA and T1D, but not in T2D. Conversely, BMI was associated with higher stiffness only in T2D. In LADA, low c-peptide (<0.3 ng/ml) was associated to higher stiffness (2.3 [2.3-2.7] Kpa vs 2.1 [2-2.3], p=0.023). Conclusion: AStif is prevalent and not associated with Ste or BMI in LADA, similarly to T1D and differently from T2D, suggesting that mechanisms of liver disease differ among diabetes types, independently from BMI. Disclosure E. Maddaloni: Speaker's Bureau; Abbott, AstraZeneca. Advisory Panel; Novo Nordisk, Merck Sharp & Dohme Corp. Speaker's Bureau; Eli Lilly and Company, Medicat Technologies and Devices (MTD). Other Relationship; Guidotti, Theras. Speaker's Bureau; Aurora Biopharma. A. Zurru: None. M. Zerunian: None. R. Amendolara: None. R. Risi: None. L. D'Onofrio: None. V. Cardinale: None. D. Caruso: None. A. Laghi: None. D. Alvaro: None. R. Buzzetti: Other Relationship; Abbott, Eli Lilly and Company, Sanofi, Novo Nordisk A/S, Boehringer-Ingelheim, AstraZeneca, Novartis Pharmaceuticals Corporation. Funding European Union through Italian Ministry of University and Research, PRIN project #2022NS7PRM

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