Elastographic evaluation for fatty liver disease in north Indian children and adolescents with type 1 diabetes

Vinod Gupta; Devi Dayal; Anmol Bhatia; Naresh Sachdeva; Sadhna Lal; Anju Bala; Savita Verma Attri

doi:10.1515/jpem-2024-0627

Article

Elastographic evaluation for fatty liver disease in north Indian children and adolescents with type 1 diabetes

Vinod Gupta , Devi Dayal , Anmol Bhatia , Naresh Sachdeva , Sadhna Lal , Anju Bala and Savita Verma Attri

Published/Copyright: January 21, 2025

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 38 Issue 3

Abstract

Objectives

The prevalence and predisposing factors to metabolic dysfunction-associated fatty liver disease (MAFLD) in children with type 1 Diabetes (T1D) living in developing countries are unknown.

Methods

A cross-sectional study was conducted in children with T1D. The presence of liver fat and tissue stiffness were assessed by ultrasonography and shear-wave elastography (SWE), respectively. The SWE values were correlated to body mass index (BMI), glycemic control, disease duration, and gamma-glutamyl transferase (GGT). Healthy non-obese children (n=36) were recruited as controls.

Results

One hundred children with T1D were grouped (Group A-C) according to the disease duration (<5, 5–10, and >10 years, respectively). The mean diabetes duration and glycated hemoglobin were 5.9 ± 4.0 years and 8.2 ± 0.55 %, respectively. The mean SWE values were significantly higher in the patient groups compared to controls (5.07 ± 0.67, 5.27 ± 0.65, 5.16 ± 0.50, vs. 4.80 ± 0.82 kPa, p-value 0.006). The liver stiffness based on SWE showed a positive but weak relationship with BMI, diabetes duration, glycemic control, and GGT levels. A significantly higher number of children with T1D had MAFLD [9(20 %), 7(24.1 %), 7(26.9 %), vs. 1(3 %), p-value <0.001] based on ultrasonography.

Conclusions

Children with T1D showed higher liver stiffness values than controls. A weakly positive relationship of liver stiffness was observed with BMI, duration of diabetes, glycemic control, and serum GGT. Approximately one-fourth of children with diabetes showed sonographic evidence of hepatic steatosis. Larger studies are needed to ascertain the effects of obesity, diabetes duration, and metabolic control on the prevalence and progression of MAFLD in children with T1D.

Keywords: type 1 diabetes; fatty liver disease; shear wave elastography; children

Corresponding author: Devi Dayal, Endocrinology and Diabetes Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India, E-mail: drdevidayal@gmail.com

Research ethics: The Institute’s Ethics Committee approved the study (IEC-INT/2022/DM-MCh-253).
Informed consent: Informed consent was obtained from all individuals included in this study, or their legal guardians or wards.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Use of Large Language Models, AI and Machine Learning Tools: None declared.
Conflict of interest: The authors state no conflict of interest.
Research funding: None declared.
Data availability: The data that support the findings of this study are available on reasonable request from the corresponding author.

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Received: 2024-08-08

Accepted: 2025-01-09

Published Online: 2025-01-21

Published in Print: 2025-03-26

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Articles in the same Issue

https://doi.org/10.1515/jpem-2024-0627

Keywords for this article

type 1 diabetes; fatty liver disease; shear wave elastography; children