Playing sports may lower insulin resistance, reduce odds for MASLD in type 1 diabetes
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Key takeaways:
- Physical activity time per week was not tied to insulin resistance or liver measures for adults with type 1 diabetes.
- Those who played sports were less likely to have MASLD than those who did not play sports.
Adults with type 1 diabetes who play sports have less insulin resistance and are less likely to develop metabolic dysfunction-associated steatotic liver disease, according to study findings.
“Participants performing regular exercise training — a possible proxy for healthy lifestyle — had a lower degree of insulin resistance and lower odds for [metabolic dysfunction-associated steatotic liver disease] compared to those not participating in sports,” Marieke de Vries, MD, researcher in the department of internal medicine at University Medical Center Utrecht in the Netherlands, and colleagues wrote in a study published in Diabetic Medicine. “This underlines the relevance of lifestyle management in type 1 diabetes clinical care.”
Researchers conducted a cross-sectional study with data from 254 adults with type 1 diabetes from two different cohorts (mean age, 44 years; 56% men). The first cohort consisted of 104 adults aged 18 to 80 years with type 1 diabetes who participated in the Utrecht Cardiovascular Cohort — Second Manifestations of Arterial Disease (UCC-SMART) study from 2002 to November 2018. The second cohort included 150 adults with type 1 diabetes who were assessed for metabolic dysfunction-associated steatotic liver disease, or MASLD, which is the new nomenclature for nonalcoholic fatty liver disease. Estimated glucose disposal rate (eGDR) was used to measure insulin resistance, with a lower value indicating higher insulin resistance. Transient elastography, controlled attenuation parameter and liver stiffness measurement were used to assess MASLD. Adults were considered to have MASLD if they had a controlled attenuation parameter of 274 dB/m or higher with or without fibrosis. Physical activity was self-reported and converted into metabolic equivalent of task hours per week per activity. Participants also self-reported whether they played sports.
Median eGDR for the study group was 7.31 mg/kg/min. Of the 150 adults in the second cohort, 20% were diagnosed with MASLD.
In linear and logistic regression analysis, no associations were found between physical activity and insulin resistance. There were also no associations between physical activity and controlled attenuation parameter, liver stiffness measurement and the presence of MASLD.
In secondary analysis, adults who said they participated in sports had a higher eGDR (beta = 0.94; 95% CI, 0.48-1.41; P < .001), lower controlled attenuation parameter (beta = –34.02; 95% CI, –48.98 to –19.05; P < .001) and lower liver stiffness measurement (beta = –0.98; 95% CI, –1.53 to –0.43; P = .001) than those who did not participate in sports. Adults who played sports were 79% less likely to have MASLD than those who did not play sports (OR = 0.21; 95% CI, 0.08-0.56; P = .002).
The researchers said one limitation of the study was administering a questionnaire to measure physical activity and being unable to classify participants as either active or inactive.
“In our study, we could not distinguish between sedentary vs. non-sedentary behavior and did have only limited information on physical activity intensity,” the researchers wrote. “In order to further specify physical activity guidelines in people with type 1 diabetes and to tailor lifestyle treatment with respect to influencing insulin resistance and the risk of [MASLD], future prospective accelerometer physical activity-measured studies should focus on these issues.”
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