ESPE Abstracts

Background: Type 2 diabetes (T2D) is an emerging disease in the pediatric population. The association between T2D and non-alcoholic fatty liver disease (NAFLD) has been described; the mechanisms responsible for the development and progression of NAFLD are incompletely understood. Evidence of high Haemoglobin A1c (HbA1c) levels and the risk of diabetes complications has been demostrated. Recent evidence suggests that metabolic control may have a role in the development and progression of NAFLD.

Objective: To evaluate the effect of metabolic control on the percentage of liver fat in T2D youths.

Material and method: This Cross-sectional study included a total of 47 adolescents with T2D, who attended the Diabetes Care Clinic of the Children’s Hospital of Mexico Federico Gomez. The protocol was approved by the local Ethics and Research Committees. The characteristics of the study were explained to all the participants; a complete clinical history, anthropometry and physical examination were performed. To evaluate the average of liver fat, the imaging estimated proton density fat fraction (PDFF) was determined by magnetic resonance (MR). The HbA1c levels were analyzed by high performance liquid chromatography; we obtained an average of 12 HbA1c levels per patient (2years).

Results: Mean age was 15.6 ± 1.75 years, and body mass index (BMI) was 25.1 ± 4.6 kg/m². Considering the average PDFF threshold of 6.5% or higher, we had 31 adolescents with NAFLD and 16 without NAFLD. The frequency of NAFLD was 66%, 45% was mild, 39% moderate, and 16% severe. The HbA1c% average was higher in subjects with NAFLD (7.3 ± 1.0 % vs. 8.2 ± 2.2 %, P = <0.05). We observed an association between the percentage of liver fat and HbA1c% (<P = 0.001). After a multivariable analysis, the association was non-significant when we adjusted for age, sex, BMI or Tanner score. With the exception of the association between the percentage of liver fat and HbA1c which remained significant after adjustment for diabetes duration and severity of NAFLD.

Conclusions: In adolescents with T2D, high HbA1c levels are associated with increased of the percentage of liver fat (PDFF). Further investigation is warranted to determine if the metabolic control of pediatric patients with T2D has a role in the development and progression of NAFLD.