Prevalence and Risk Factors of Metabolic-Associated Hepatic Steatosis in Individuals Living With Type 1 Diabetes (STEA-DT1)
The goal of this observational cross-sectional study is to assess the prevalence and stage of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), specifically liver steatosis and fibrosis in adults aged 18 and older living with type 1 diabetes or Latent Autoimmune Diabetes in Adults (LADA) in Quebec.
The main questions it aims to answer are:
- What is the prevalence and severity of liver steatosis and fibrosis among people living with type 1 diabetes in Québec?
- Are there patients with type 1 diabetes who have advanced, undiagnosed stages of liver disease that require management but are missed by current standard care practices?
Researchers will compare three participant subgroups based on adiposity (a control group without increased adiposity, an overweight group with increased adiposity, and an obesity group with increased adiposity) to see if the prevalence and severity of hepatic steatosis and fibrosis are highest in the obesity group and lowest in the control group. They will also explore if variables and potential risk factors associated with liver disease differ across these subgroups.
Participants will attend a single study visit where they will be asked to:
- Provide clinical data through laboratory analyses.
- Undergo specific clinical procedures.
- Complete validated questionnaires.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Élisabeth Nguyen, DtP, M.Sc
- Phone Number: (514) 987-5617
- Email: elisabeth.nguyen@ircm.qc.ca
Study Contact Backup
- Name: Valérie Parent
- Email: valerie.parent@ircm.qc.ca
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Individuals ≥ 18 years of age.
- A clinical diagnosis of type 1 diabetes or Latent Autoimmune Diabetes in Adults (LADA) for at least one year, as per the investigators' clinical judgment (confirmatory C-peptide and antibodies will not be required).
Exclusion Criteria:
- Alcohol consumption exceeding 20g per day in women or 30g per day in men.
- Known chronic liver disease (including viral, drug-induced, Wilson disease, deficit in alpha-1-antirypsin, hemochromatosis, autoimmune hepatitis, etc.).
- Evidence of cirrhosis based on a result of liver biopsy, or history of portal hypertension presented by ascites, hepatic encephalopathy or varices.
- History of use of medications known to induce liver steatosis, including corticosteroids, high-dose estrogens, tamoxifen, methotrexate, amiodarone, or tetracycline.
- Ongoing pregnancy.
- Life expectancy of less than 5 years, as per investigators' clinical judgment.
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Control group
Adults with type 1 diabetes or LADA without increased adiposity and without any BMI-based criterion.
|
Participants are classified into three subgroups based on their BMI and the presence of increased adiposity.
Increased adiposity is defined by waist circumference, waist-to-hip ratio, or waist-to-height ratio exceeding sex- and ethnicity-specific thresholds.
The subgroups are: a control group (no increased adiposity), an overweight group (BMI 25.0-29.9
kg/m² with increased adiposity), and an obesity group (BMI ≥ 30 kg/m² with increased adiposity).
|
|
Obesity Group
Adults with T1D or LADA with a BMI of 30 kg/m² or higher combined with increased adiposity.
|
Participants are classified into three subgroups based on their BMI and the presence of increased adiposity.
Increased adiposity is defined by waist circumference, waist-to-hip ratio, or waist-to-height ratio exceeding sex- and ethnicity-specific thresholds.
The subgroups are: a control group (no increased adiposity), an overweight group (BMI 25.0-29.9
kg/m² with increased adiposity), and an obesity group (BMI ≥ 30 kg/m² with increased adiposity).
|
|
Overweight group
Adults with T1D or LADA with a BMI between 25.0 and 29.9 kg/m² combined with increased adiposity
|
Participants are classified into three subgroups based on their BMI and the presence of increased adiposity.
Increased adiposity is defined by waist circumference, waist-to-hip ratio, or waist-to-height ratio exceeding sex- and ethnicity-specific thresholds.
The subgroups are: a control group (no increased adiposity), an overweight group (BMI 25.0-29.9
kg/m² with increased adiposity), and an obesity group (BMI ≥ 30 kg/m² with increased adiposity).
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Assessment of liver fibrosis using FibroScan
Time Frame: Baseline (Day 1 / Single Study Visit)
|
Liver fibrosis severity will be quantified using liver stiffness measurement (LSM) obtained via FibroScan.
The measurement is expressed in kilopascals (kPa).
Higher values indicate more severe fibrosis, categorized as: < 8.0 kPa (Normal), 8.0 to 9.6 kPa (Significant fibrosis), 9.7 to 13.5 kPa (Advanced fibrosis), and > 13.5 kPa (Cirrhosis)
|
Baseline (Day 1 / Single Study Visit)
|
|
Degree of liver steatosis assessment
Time Frame: Baseline (Day 1 / Single Study Visit)
|
Liver steatosis will be quantified using the Controlled Attenuation Parameter CAP value generated simultaneously during the FibroScan assessment.
The measurement is expressed in decibels per meter (dB/m).
Higher values indicate a higher degree of steatosis, categorized as: < 294 dB/m (<5% steatosis), 294 to 310 dB/m (5 to 30%), 311 to 330 dB/m (30 to 60%), and > 330 dB/m (>60%).
|
Baseline (Day 1 / Single Study Visit)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Anthropometric Assessment: Body mass Index (BMI)
Time Frame: Baseline (Day 1 / Single Study Visit)
|
Body mass index (BMI: kg/m^2) will be calculated using weight (kg) and height (cm) to compare FibroScan results across predefined subgroups.
|
Baseline (Day 1 / Single Study Visit)
|
|
Anthropometric Assessment: Waist circumference
Time Frame: Baseline (Day 1 / Single Study Visit)
|
Waist circumference and hip circumference (cm) will be used to compare FibroScan results across predefined subgroups.
|
Baseline (Day 1 / Single Study Visit)
|
|
Adiposity-Based Subgroup Classification
Time Frame: Baseline (Day 1 / Single Study Visit)
|
Participants will be categorized into three groups (e.g., Low, Medium, High adiposity) based on a composite of iDXA
|
Baseline (Day 1 / Single Study Visit)
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Dietary Intake (RxFood Diary)
Time Frame: Baseline (Day 1 / Single Study Visit)
|
Average daily caloric intake calculated over 3 days
|
Baseline (Day 1 / Single Study Visit)
|
|
Alcohol Use Disorders Identification Test (AUDIT) Score
Time Frame: Baseline (Day 1 / Single Study Visit)
|
Total score from the 10-item AUDIT questionnaire to assess alcohol consumption.
Range: 0 to 40.
A higher score indicates a greater risk of hazardous and harmful alcohol use, as well as potential alcohol dependence (A score of 8 or more is typically considered the threshold for hazardous drinking).
|
Baseline (Day 1 / Single Study Visit)
|
|
Physical Activity Level (IPAQ)
Time Frame: Baseline (Day 1 / Single Study Visit)
|
Total physical activity expressed as Metabolic Equivalent of Task (MET)-minutes per week.
A higher score (higher MET-minutes/week) indicates a higher level of physical activity.
|
Baseline (Day 1 / Single Study Visit)
|
|
Eating Behavior (Three-Factor Eating Questionnaire: TFEQ)
Time Frame: Baseline (Day 1 / Single Study Visit)
|
The TFEQ-R18 is an 18-item validated tool used to assess three domains of eating behavior: Cognitive Restraint, Uncontrolled Eating, and Emotional Eating.
Raw scores are transformed to a 0-100 scale.
For all sub-scales, higher scores indicate a greater presence of that specific eating behavior (e.g., higher emotional eating or higher restraint).
|
Baseline (Day 1 / Single Study Visit)
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Rémi Rabasa-Lhoret, M.D. Ph.D, Institut de recherches cliniques de Montreal
- Principal Investigator: Sarah Béland-Bonenfant, M.D. Ph.D, Institut de recherches cliniques de Montreal
Publications and helpful links
General Publications
- Lalanne-Mistrih ML, Bonhoure A, Messier V, Boudreau V, Lebbar M, Talbo MK, Sun CJ, Bandini A, Secours L, Calderon V, Grou C, Tressieres B, Brazeau AS, Rabasa-Lhoret R. Overweight and Obesity in People Living With Type 1 Diabetes: A Cross-Sectional Analysis of the BETTER Registry. Diabetes Metab Res Rev. 2024 Sep;40(6):e3837. doi: 10.1002/dmrr.3837.
- European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol. 2024 Sep;81(3):492-542. doi: 10.1016/j.jhep.2024.04.031. Epub 2024 Jun 7.
- Souza M, Al-Sharif L, Khalil SM, Villela-Nogueira CA, Mantovani A. Global Epidemiology and Characteristics of Metabolic Dysfunction-associated Steatotic Liver Disease in Type 1 Diabetes Mellitus: An Updated Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2025 Jul;23(8):1308-1319.e17. doi: 10.1016/j.cgh.2024.09.038. Epub 2024 Dec 11.
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Endocrine System Diseases
- Pathologic Processes
- Metabolic Diseases
- Autoimmune Diseases
- Immune System Diseases
- Digestive System Diseases
- Glucose Metabolism Disorders
- Diabetes Mellitus
- Liver Diseases
- Fibrosis
- Pathological Conditions, Signs and Symptoms
- Nutritional and Metabolic Diseases
- Fatty Liver
- Diabetes Mellitus, Type 1
- Liver Cirrhosis
- Diagnostic Techniques and Procedures
- Diagnosis
- Physiological Phenomena
- Biochemical Phenomena
- Chemical Phenomena
- Physical Examination
- Body Weights and Measures
- Body Constitution
- Metabolism
- Body Fat Distribution
- Body Composition
- Adiposity
Other Study ID Numbers
Other Study ID Numbers
- 2026-1350
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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