Non-Invasive Screening of Metabolic Dysfunction-Associated Fatty Liver Disease MAFLD among People with Type 1 Diabetes Mellitus

Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) encompasses hepatic steatosis with potential progression to steatohepatitis and fibrosis. It represents a principal contributor to end-stage liver disease. Indirect assessment of hepatic involvement can be achieved through non-invasive tools such as fatty liver index (FLI) and fibrosis-4 index (FIB-4). Aim: This study aimed to screen for MAFLD in individuals with T1DM using non-invasive scores (FLI and FIB-4) and amino-terminal propeptide of P3NP. Patients and methods: In this cross-sectional analysis, a total of 82 cases diagnosed with T1DM were categorized into low, intermediate, and high-risk groups according to the FLI. The evaluation of FIB-4 and P3NP levels was primarily conducted within the intermediate- and high-risk subgroups. Results: Higher FLI scores were significantly associated with older age, female sex, longer T1DM duration, higher BMI, and elevated blood pressure. FLI also showed significant correlation with FIB-4. FIB-4 positively correlated with T1DM duration, BMI, systolic and diastolic blood pressure (SBP and DBP), and waist circumference. P3NP showed a significant correlation with FIB-4 but not with FLI. Conclusion: FLI is a valid tool for non-invasive detection of hepatic steatosis in T1DM cases. FIB-4 can further stratify fibrosis risk without the need for invasive procedures. However, P3NP showed limited utility in this context.