Background: The liver is one of the most important organs in glucose metabolism and closely related to diabetes pathophysiology. Non-alcoholic fatty liver disease (NAFLD) is well known in type 2 diabetes mellitus (DM), but also adult patients with type 1 DM are at increased risk for NAFLD.
Objective and hypotheses: Here, we studied the prevalence of liver disease in a representative number of children and adolescents with type 1 DM in Germany.
Method: We used laboratory investigations, ultrasound, and liver stiffness measurements (Fibroscan and acoustic radiation force imaging) as noninvasive screening methods for liver disease in a cross-sectional analysis of n=93 children and adolescents with type 1 DM.
Results: Eighty-one patients (87%) had completely normal results. Only four patients (4.3%) had significant indicators of NAFLD (increased liver stiffness, elevated liver transaminases). Of these, three were overweight/obese and all four had suboptimal glycemic control with HbA1c >58 mmol/mol (>7.5%). Eight patients (8.6%) showed only one single mildly pathologic aspect of the examined items, in summary probably not indicating significant hepatic pathology. Variables indicating hepatic abnormalities did not show any correlation with HbA1c, body mass index, or diabetes duration.
Conclusions: Our results do not indicate a significantly increased prevalence of liver pathology in this cohort compared to prevalence data from the general population. Therefore, our data advocate against systematic screening for liver disease in paediatric patients with type 1 DM.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology