ESPE Abstracts

Backgound: Type 1 diabetes mellitus (T1DM) is one of the chronic disease frequently encountered in childhood and the non-alcoholic fatty liver disease is one of the uncommon complications in the management of these patients.

Objective and hypotheses: In this study, we aimed to investigate the relationship between serum fetuin-A levels which a negative acute phase reactant and the non-alcoholic fatty liver disease in T1 diabetic patients.

Methods: Serum fetuin-A levels were measured and liver ultrasonography were performed in addition to the routine tests to 80 patients (Male/Famele: 1/1) which had T1DM at least 5 years. Patients were divided in to two groups, with/without hepatic steatosis (HS+/HS−) according to ultrasonography. Two groups were compared for age, gender, anthropometric parameters (waist/neck circumference, BMI, lean body mass (LBM), body fat ratio), serum lipid profile, liver function tests, DM duration, daily insulin requirements, glycemic controls and serum fetuin-A levels.

Results: Eight (10%) patients presented hepatic steatosis (grade 1). The BMI, body fat ratio, waist circumference, HbA1c, ALT, GGT and total cholesterol levels were significantly higher in HS+ group than HS−. There was no difference between two groups for age, DM duration, neck circumference, LBM, BMI at the time of diagnosis and insulin requirements. The median level of fetuin-A HS+ cases was 619.84 μg/ml, HS− cases was 378.36 μg/ml and the levels difference was statistically significant (P<0.001). Hyperlipidemia, poor glycemic control, BMI, waist circumference and body fat ratio was positive correlated with serum fetuin-A levels.

Conclusion: We conclude that hepatosteatosis is more common with T1DM cases who had poor glycemic and metabolic control, in addition fetuin-A is a reliable parameter for diagnosis and follow up T1DM patients with hepatic steatosis.