Markers of Early Liver Dysfunction Associate With Reduced Heart Rate Variability in Adolescents With Type 1 Diabetes
Authors' conclusion
Higher ALT and GGT associate with early CAN in adolescents with type 1 diabetes, suggesting hepatic inflammation may compound the impact of the diabetes milieu on systemic endothelial dysfunction.
Study context
- Population
- Adolescents with T1D (mean age 14.7 ± 1.9 years)
- Participants
- 102 adolescents
- Exposure
- Upper ALT and gamma-glutamyl transferase (GGT) tertiles vs T1-2
- Outcome
- Early cardiac autonomic nerve dysfunction (CAN): ≥1 abnormality in seven heart rate variability parameters from a 10-min resting ECG
- Follow-up
- Median 3.5 years (IQR 2.7-4.6)
Methodological detailsrepeated annual complications assessments, multivariate generalized estimating equations
- Repeated annual complications assessments
- Multivariate generalized estimating equations
Main finding
As reported in the abstract
CAN development · median follow-up 3.5 years
Each group vs T1-2Estimate (95% CI)
T3
OR (ALT tertile) 2.05(1.20–3.48)
T3
OR (GGT tertile) 2.99(1.61–5.58)
- CAN developed
- 23%, n = 24
Observational data: associations, not effects.
Further findings
Retinopathy and early kidney dysfunction
- Upper ALT and GGT tertiles not associated with retinopathy or early kidney dysfunction
ALT and systolic blood pressure (SBP) percentiles over follow-up · median follow-up 3.5 years
- Significant increases in mean ALT and SBP percentiles
Original publication
Markers of Early Liver Dysfunction Associate With Reduced Heart Rate Variability in Adolescents With Type 1 Diabetes. Pediatr Diabetes. Published 15 May 2025. doi:10.
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