Liver disease in children and adolescents with type 1 diabetes mellitus: A link between glycemic control and hepatopathy. (December 2020)

• Record Type: Journal Article
• Authors: El-Sayed, Manal H.; Thabet, Rasha A.; Hamza, Mohamed T.; Hussein, Muhammad S.; El Saeed, Maha M.
• Is Part Of: Diabetes research and clinical practice. Volume 170(2020)
• Publication Date: 2020-12
• Subjects: Type 1 diabetes mellitus -- Liver disease -- Fibroscan -- Glycemic control; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2020.108458
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Liver disease is not uncommon in patients with type 1 diabetes. Fibroscan is a non-invasive method for assessment of patients with liver disease and is useful tool for follow up. Adequate glycemic control is the cornerstone in management of liver disease in children and adolescents with diabetes. Abstract: Aim: The aim of this study was to assess the prevalence of liver disease in children and adolescents with type-1 diabetes mellitus (T1DM) by detection of elevated liver transaminases, confirmed by fibroscan and ultrasound. The secondary objective was to assess the effect of glycemic control on improvement of liver functions. Methods: One hundred and seven children and adolescents with T1DM were investigated by liver transaminases, mean HbA1c and pelviabdominal ultrasound while fibroscan was done for those with elevated liver transaminases only. Patients with elevated liver enzymes were reassessed after one year. Results: Only nine (8.4%) of the studied patients have exhibited liver dysfunction in the form of elevated liver transaminases with median ALT 140 U/L and AST 191 U/L and hepatomegaly by ultrasound; The HbA1c (median = 10.8%) and fibroscan abnormalities (median fibrosis score 1) were significantly higher in patients with elevated liver transaminases (p < 0.001). Adequate glycemic control resulted in a significant decrease in liver transaminases (median ALT = 25 U/L and AST = 29 U/L), fibroscan fibrosis score (median = 0) and HbA1c (median = 9%) (p = 0.003), (p = 0.01) and (p = 0.003) respectively. Conclusion: Adequate glycemic control was associated with improvement of liver disease in children and adolescents with diabetes.