{
  "abstract": "Introduction Screening for Metabolic Associated Steatotic Liver Disease (MASLD) is recommended in those with Type 2 Diabetes Mellitus, or high-risk obese individuals. There is limited literature on screening for MASLD in those with T1DM, but metabolic syndrome is increasingly recognised in this group. Here we present data from MASLD screening in T1DM patients in NHS Tayside.Methods iDiabetesPlus, a precision medicine platform, is being tested in 16 general practices in NHS Tayside. All patients with diabetes receive ALT and FIB4 at their annual diabetes review. Those with ALT>30 receive additional NAFLD Fibrosis Score(NFS), and those with indeterminate FIB4 or NAFLD fibrosis scores cascade Enhanced Liver Fibrosis Score(ELF) testing. If FIB4 >2.67, NFS>0.675, or ELF ≥9.8, an automated hepatology referral is generated.Laboratory, clinical and Fibroscan results were reviewed. Age-dependent cut offs to stratify FIB4 results into low, intermediate and high risk were used. We compared variables of interest between low and intermediate/high FIB4 groups using chi-squared test.Results From 28/10/2024 to 31/12/2025, 359 (201 male, median age 54 years) patients with T1DM were enrolled in iDiabetesPlus and 349(97.2%) had successful FIB4 calculation. A higher proportion of individuals in the intermediate/high FIB4 groups were prescribed lipid lowering therapy (65.8% vs 47.4%; p=0.049). There were no significant differences in proportion with systolic blood pressure above 130mmHg, BMI>30kg/m 2, or HbA1c>58mmol/mol between both groups, see table 1.17 patients met ELF testing thresholds. 10 were <9.8, 5 were 9.8-10.5 and 2 were >10.5. Automated hepatology referrals were generated for 10 individuals, 9 of whom underwent Fibroscan. 2 patients had liver stiffness measurement(LSM) 10-15kPa but none had LSM>15kPa.Conclusions In our T1DM cohort undergoing MASLD screening, individuals with higher risk FIB4 scores were more likely to be prescribed lipid lowering therapy. In those who warranted Fibroscan, we identified a low number of possible cases of compensated advanced chronic liver disease and no definitive cases. Given the overall very low rates of likely advanced fibrosis detected, this study does not support universal fibrosis screening in people with T1DM. However, subpopulations within T1DM may benefit from targeted MASLD screening.Abstract P78 Table 1SubgroupLow RiskIntermediate RiskHigh Riskp-value╪N(%)311 (89.1%)34 (9.7%)4 (1.1%)Blood PressureSystolic BP<130mmHg154 (92.8%)11 (6.6%)1 (0.6%)p= 0.055Systolic BP≥130mmHg157 (85.8%)23 (12.6%)3 (1.6%)Lipid Lowering TherapyPrescribed 147 (85.5%)22 (12.8%)3 (1.7%)p=0.049Not prescribed 163 (92.6%)12 (6.8%)1 (0.6%)BMI BMI<30kg/m2205 (88.4%)24 (10.3%)3 (1.3%)p=0.652BMI>30kg/m2106 (90.6%)10 (8.5%)1 (0.9%)HbA1cHbA1c<58mmol/mol77 (86.5%)11 (12.4%)1 (1.1%)p=0.476HbA1c>58mmol/mol234 (90.0%)23 (8.8%)3 (1.2%)*low: <1.3 if age <65 years, <2.0 if age >65 years; high: > 2.67╪chi-squared test; p-value below 0.05 indicates significance",
  "authors": [
    {
      "affiliations": [
        "Ninewells Hospital and Medical School, Dundee, United Kingdom"
      ],
      "name": "Rachael Barrett"
    },
    {
      "affiliations": [
        "Ninewells Hospital and Medical School, Dundee, United Kingdom"
      ],
      "name": "Damien Leith"
    },
    {
      "affiliations": [
        "Ninewells Hospital and Medical School, Dundee, United Kingdom"
      ],
      "name": "YeunYi Lin"
    },
    {
      "affiliations": [
        "Ninewells Hospital and Medical School, Dundee, United Kingdom"
      ],
      "name": "Mya Win"
    },
    {
      "affiliations": [
        "Ninewells Hospital and Medical School, Dundee, United Kingdom"
      ],
      "name": "Evelyn Enyebe"
    },
    {
      "affiliations": [
        "Ninewells Hospital and Medical School, Dundee, United Kingdom"
      ],
      "name": "Samira Bell"
    },
    {
      "affiliations": [
        "Ninewells Hospital and Medical School, Dundee, United Kingdom"
      ],
      "name": "Ruairi Lynch"
    },
    {
      "affiliations": [
        "Ninewells Hospital and Medical School, Dundee, United Kingdom"
      ],
      "name": "Ewan Pearson"
    },
    {
      "affiliations": [
        "Ninewells Hospital and Medical School, Dundee, United Kingdom"
      ],
      "name": "John F Dillon"
    }
  ],
  "title": "P78 Low risk of advanced liver fibrosis in type 1 diabetes despite metabolic risk factors – results from universal fib4 screening",
  "uid": "a62706f3-f6af-5360-bbbd-989f0e09b8ee"
}