Clinical and diagnostic characteristics of non-alcoholic fatty liver disease among Egyptian children and adolescents with type1 diabetes
Abstract Background Type 1 diabetes mellitus (T1DM) patients are at an increased risk for non-alcoholic fatty liver disease (NAFLD). This study aimed to evaluate the clinical criteria associated with the diagnosis of Non-Alcoholic Fatty Liver Disease (NAFLD) among T1DM Egyptian children and adolesce...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Diabetology & Metabolic Syndrome |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13098-023-01029-6 |
| _version_ | 1797864016365748224 |
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| author | Hanaa Reyad Abdallah Eman Refaat Youness Manar Maher Bedeir Marwa W. Abouelnaga Wafaa M. Ezzat Yasser Elhosary Hazem Mohamed El-Hariri Mona Abd Elmotaleb A. Hussein Heba R. Ahmed Rasha Eladawy |
| author_facet | Hanaa Reyad Abdallah Eman Refaat Youness Manar Maher Bedeir Marwa W. Abouelnaga Wafaa M. Ezzat Yasser Elhosary Hazem Mohamed El-Hariri Mona Abd Elmotaleb A. Hussein Heba R. Ahmed Rasha Eladawy |
| author_sort | Hanaa Reyad Abdallah |
| collection | DOAJ |
| description | Abstract Background Type 1 diabetes mellitus (T1DM) patients are at an increased risk for non-alcoholic fatty liver disease (NAFLD). This study aimed to evaluate the clinical criteria associated with the diagnosis of Non-Alcoholic Fatty Liver Disease (NAFLD) among T1DM Egyptian children and adolescents. Methods 74 T1DM patients aged 8–18 year were enrolled in this cross sectional study. Assessments of Clinical status, anthropometric measures, lipid profile, glycated haemoglobin (HbA1c) and liver enzymes were done. Abdominal Ultrasound evaluation of hepatic steatosis was done. Accordingly, patients were divided into two groups (NAFLD and normal liver group) and compared together. Assessment of liver fibrosis using acoustic radiation force impulse elastography (ARFI) was done. Statistical analysis included; independent t-test, Chi square and Fisher’s Exact, Pearson and Spearman tests and Logistic regression models for factors associated with fatty liver were used when appropriate. Results In this study; 74 patients were enrolled; 37 males (50%) and 37 females with mean age 14.3 ± 3.0 year. The mean insulin dose was 1.1 ± 0.4 U/kg and mean disease duration was 6.3 ± 3.0 year. NAFLD was detected in 46 cases while 28 cases had normal liver as diagnosed by abdominal ultrasound. Cases with NAFLD had statistically significant higher BMI-Z scores, waist/hip, waist/height and sum of skin fold thicknesses compared to those with normal liver (P < 0.05). The mean value of HbA1c % was significantly higher in NAFLD group (P = 0.003). Total cholesterol, triglycerides and LDL serum levels were significantly elevated (p < 0.05), while the HDL level was significantly lower in NAFLD cases (p = 0.001). Although, serum levels of liver enzymes; ALT and AST were significantly higher among cases with NAFLD than in normal liver group (p < 0.05), their means were within normal. Using the ARFI elastography; NAFLD cases exhibited significant fibrosis (F2, 3 and 4). BMI, patient age and female gender were among risk factors for NAFLD. Conclusions NAFLD represents a serious consequence in type 1 diabetic children and adolescents that deserves attention especially with poor glycemic control. NAFLD has the potential to evolve to fibrosis. This study demonstrated a very high prevalence of NAFLD in T1D children and adolescents using US which was (62.2%) with the percent of liver fibrosis among the NAFLD cases (F2-F4) using ARFI elastography was 26%. BMI, age of patients and female gender were detected as risk factors for NAFLD. |
| first_indexed | 2024-04-09T22:44:49Z |
| format | Article |
| id | doaj.art-6429abb6104748999019ebbd2bbdd900 |
| institution | Directory Open Access Journal |
| issn | 1758-5996 |
| language | English |
| last_indexed | 2024-04-09T22:44:49Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj.art-6429abb6104748999019ebbd2bbdd9002023-03-22T11:55:45ZengBMCDiabetology & Metabolic Syndrome1758-59962023-03-0115111310.1186/s13098-023-01029-6Clinical and diagnostic characteristics of non-alcoholic fatty liver disease among Egyptian children and adolescents with type1 diabetesHanaa Reyad Abdallah0Eman Refaat Youness1Manar Maher Bedeir2Marwa W. Abouelnaga3Wafaa M. Ezzat4Yasser Elhosary5Hazem Mohamed El-Hariri6Mona Abd Elmotaleb A. Hussein7Heba R. Ahmed8Rasha Eladawy9Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research CentreMedical Biochemistry Department, Medical Research and Clinical Studies Institute, National Research CentreChild Health Department, Medical Research and Clinical Studies Institute, National Research CentreChild Health Department, Medical Research and Clinical Studies Institute, National Research CentreInternal Medicine Department, Medical Research and Clinical Studies Institute, National Research CentreInternal Medicine Department, Medical Research and Clinical Studies Institute, National Research CentreCommunity Medicine Department, Medical Research and Clinical Studies Institute, National Research CentreNational Institute of Diabetes and EndocrinologyNational Institute of Diabetes and EndocrinologyFaculty of Medicine, Ain Shams UniversityAbstract Background Type 1 diabetes mellitus (T1DM) patients are at an increased risk for non-alcoholic fatty liver disease (NAFLD). This study aimed to evaluate the clinical criteria associated with the diagnosis of Non-Alcoholic Fatty Liver Disease (NAFLD) among T1DM Egyptian children and adolescents. Methods 74 T1DM patients aged 8–18 year were enrolled in this cross sectional study. Assessments of Clinical status, anthropometric measures, lipid profile, glycated haemoglobin (HbA1c) and liver enzymes were done. Abdominal Ultrasound evaluation of hepatic steatosis was done. Accordingly, patients were divided into two groups (NAFLD and normal liver group) and compared together. Assessment of liver fibrosis using acoustic radiation force impulse elastography (ARFI) was done. Statistical analysis included; independent t-test, Chi square and Fisher’s Exact, Pearson and Spearman tests and Logistic regression models for factors associated with fatty liver were used when appropriate. Results In this study; 74 patients were enrolled; 37 males (50%) and 37 females with mean age 14.3 ± 3.0 year. The mean insulin dose was 1.1 ± 0.4 U/kg and mean disease duration was 6.3 ± 3.0 year. NAFLD was detected in 46 cases while 28 cases had normal liver as diagnosed by abdominal ultrasound. Cases with NAFLD had statistically significant higher BMI-Z scores, waist/hip, waist/height and sum of skin fold thicknesses compared to those with normal liver (P < 0.05). The mean value of HbA1c % was significantly higher in NAFLD group (P = 0.003). Total cholesterol, triglycerides and LDL serum levels were significantly elevated (p < 0.05), while the HDL level was significantly lower in NAFLD cases (p = 0.001). Although, serum levels of liver enzymes; ALT and AST were significantly higher among cases with NAFLD than in normal liver group (p < 0.05), their means were within normal. Using the ARFI elastography; NAFLD cases exhibited significant fibrosis (F2, 3 and 4). BMI, patient age and female gender were among risk factors for NAFLD. Conclusions NAFLD represents a serious consequence in type 1 diabetic children and adolescents that deserves attention especially with poor glycemic control. NAFLD has the potential to evolve to fibrosis. This study demonstrated a very high prevalence of NAFLD in T1D children and adolescents using US which was (62.2%) with the percent of liver fibrosis among the NAFLD cases (F2-F4) using ARFI elastography was 26%. BMI, age of patients and female gender were detected as risk factors for NAFLD.https://doi.org/10.1186/s13098-023-01029-6Type1 diabetesHepatopathyNon-alcoholic fatty liver disease (NAFLD)Anthropometric measuresAcoustic radiation force impulse elastography (ARFI) |
| spellingShingle | Hanaa Reyad Abdallah Eman Refaat Youness Manar Maher Bedeir Marwa W. Abouelnaga Wafaa M. Ezzat Yasser Elhosary Hazem Mohamed El-Hariri Mona Abd Elmotaleb A. Hussein Heba R. Ahmed Rasha Eladawy Clinical and diagnostic characteristics of non-alcoholic fatty liver disease among Egyptian children and adolescents with type1 diabetes Diabetology & Metabolic Syndrome Type1 diabetes Hepatopathy Non-alcoholic fatty liver disease (NAFLD) Anthropometric measures Acoustic radiation force impulse elastography (ARFI) |
| title | Clinical and diagnostic characteristics of non-alcoholic fatty liver disease among Egyptian children and adolescents with type1 diabetes |
| title_full | Clinical and diagnostic characteristics of non-alcoholic fatty liver disease among Egyptian children and adolescents with type1 diabetes |
| title_fullStr | Clinical and diagnostic characteristics of non-alcoholic fatty liver disease among Egyptian children and adolescents with type1 diabetes |
| title_full_unstemmed | Clinical and diagnostic characteristics of non-alcoholic fatty liver disease among Egyptian children and adolescents with type1 diabetes |
| title_short | Clinical and diagnostic characteristics of non-alcoholic fatty liver disease among Egyptian children and adolescents with type1 diabetes |
| title_sort | clinical and diagnostic characteristics of non alcoholic fatty liver disease among egyptian children and adolescents with type1 diabetes |
| topic | Type1 diabetes Hepatopathy Non-alcoholic fatty liver disease (NAFLD) Anthropometric measures Acoustic radiation force impulse elastography (ARFI) |
| url | https://doi.org/10.1186/s13098-023-01029-6 |
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