P2439 - Comparing the Association of Nonalcoholic Steatohepatitis and Nonalcoholic Fatty Liver Disease With Type 1 vs Type 2 Diabetes Mellitus

Megan B. Ghai, MD, MPH, MA, Pooja Rangan, MBBS, MPH, Ma Ai Thanda Han, MD
University of Arizona College of Medicine, Phoenix, AZ

Introduction: Type two diabetes mellitus (T2DM) is a known risk factor for the development of nonalcoholic steatohepatitis (NASH) and nonalcoholic fatty liver disease (NAFLD). However, there are no population-based analyses evaluating the association between NASH/NAFLD and type one diabetes mellitus (T1DM). We aimed to characterize this association.

Methods: A retrospective analysis of U.S. inpatient discharges from 2016-2019 using Healthcare Cost and Utilization Project National Inpatient Sample was performed. Adults with T1DM or T2DM were included. Weights were used to generate nationally representative estimates. Descriptive statistics were produced using Pearson’s chi-squared tests. Mean length of stay (LOS) and mortality were calculated. Multivariate logistic regression was used to evaluate the independent association of diabetes with NASH/NAFLD and the association of covariates within the T1DM and T2DM groups.

Results: Included were 37,699,501 (4.34% T1DM, 95.66% T2DM) weighted inpatient discharges (Table 1). 1.63% of those with T1DM and 2.42% of those with T2DM had NASH/NAFLD. LOS (T2DM= +0.26 days, p < 0.01) and mortality (T2DM= 2.13% vs T1DM= 0.93%, X²(1, N=898,885)= 35.81, p < 0.001) were greater in those with T2DM. Those with T2DM had a stronger association with NASH/NAFLD than those with T1DM (aOR 2.66, 95% CI [2.48, 2.85], p < 0.001). Compared to those of White race, there was an increased association of NASH/NAFLD among Hispanic (aOR=1.38, 95% CI [1.15, 1.64], p < 0.001) and Native American (aOR=1.95, 95% CI [1.19, 3.21], p= 0.008) populations among those with T1DM. Black race had a decreased association with NASH/NAFLD among those with T1DM (aOR= 0.74, 95% CI [0.62, 0.88], p= 0.001) and T2DM (aOR= 0.53, 95% CI [0.52, 0.55], p < 0.001).

Discussion: These results demonstrated that among hospitalized diabetics, those with T2DM had a stronger association with NASH/NAFLD than those with T1DM. Severity was also higher among those with T2DM. Those of Hispanic and Native American races had stronger associations with NASH/NAFLD compared to White race among those with T1DM. White race had a stronger association with NASH/NAFLD compared to Black race in both T1DM and T2DM groups. More research needs to be conducted to further elucidate the differences in racial disparities between those with NASH/NAFLD and T1DM vs T2DM.


Disclosures:


Megan B. Ghai, MD, MPH, MA, Pooja Rangan, MBBS, MPH, Ma Ai Thanda Han, MD. P2439 - Comparing the Association of Nonalcoholic Steatohepatitis and Nonalcoholic Fatty Liver Disease With Type 1 vs Type 2 Diabetes Mellitus, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.