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Background <p>Children and adolescents with type 1 diabetes mellitus (T1DM)occasionally develop liver disorders. Glycogenic hepatopathy and non-alcoholicfatty liver disease are the most common conditions found in patients with poorglycemic control. The main purpose of the study was to determine the frequencyof liver disorders in children and adolescents with T1DM and to investigate acorrelation with chronic complications or associated autoimmune diseases. Thesecond aim was to investigate if glycogenic hepatopathy and non-alcoholic fattyliver disease could be differentiated non-invasively with MRI among patientswith T1DM.</p> Methods <p>In 154 patients with T1DM age 2–20 years, clinical exam,laboratory tests and abdominal ultrasound were performed. Liver MRI and biopsywere performed in selected patients.</p> Results <p>Over the study period, 154 patients with T1DM were investigated (77females and 77 males, ages 2–20, mean 14.2 ± 3.2years, T1DM duration 1–18 years, mean 7.7 ± 4.1years, BMI20.6 ± 3.7&#xa0;kg/m<sup>2</sup>).Intensive therapy with insulin analogues was used in 121 (78.6%), and 33patients (21.4%) were treated via insulin pumps. We did not observedelayed puberty.</p> <p>We have found hepatomegaly in 9.7% patients, elevatedtransaminases in 18.8%, ultrasound-enlarged liver in 21.7% and27.3% with abnormal echogenicity. MRI and liver biopsy were performed in9 patients. A liver biopsy revealed 8 patients with glycogenic hepatopathy andonly one with non-alcoholic fatty liver disease. MRI showed a good associationwith pathohistological findings (<i>P</i> &lt; 0.001). We did not establish a correlationbetween hepatic complications and chronic complications or associated autoimmunediseases.</p> Conclusion <p>Liver disorders in patients with T1DM are not as rare as previouslythought, and glycogenic hepatopathy is the most common. A combination of liverenzymes and a liver ultrasound exam is a good initial screening and follow-upmethod for the evaluation of liver disorders. MRI represents a good non-invasivetool for the distinction between glycogen and fat accumulation, and mightpostpone liver biopsy beyond initial workup.</p>

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Prevalence of liver disorders in children and adolescents with type 1 diabetes mellitus

  • 期刊论文

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  • 发表日期：

    2025年8月4日

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  • Mirna Natalija Anicic,
  • Katja Dumic ,
  • Lucija Kolega Mrkic,
  • Anita Spehar Uroic,
  • Nevena Krnic,
  • Martina Zidanic,
  • Marijana Coric,
  • Jurica Vukovic

摘要

Background

Children and adolescents with type 1 diabetes mellitus (T1DM)occasionally develop liver disorders. Glycogenic hepatopathy and non-alcoholicfatty liver disease are the most common conditions found in patients with poorglycemic control. The main purpose of the study was to determine the frequencyof liver disorders in children and adolescents with T1DM and to investigate acorrelation with chronic complications or associated autoimmune diseases. Thesecond aim was to investigate if glycogenic hepatopathy and non-alcoholic fattyliver disease could be differentiated non-invasively with MRI among patientswith T1DM.

Methods

In 154 patients with T1DM age 2–20 years, clinical exam,laboratory tests and abdominal ultrasound were performed. Liver MRI and biopsywere performed in selected patients.

Results

Over the study period, 154 patients with T1DM were investigated (77females and 77 males, ages 2–20, mean 14.2 ± 3.2years, T1DM duration 1–18 years, mean 7.7 ± 4.1years, BMI20.6 ± 3.7 kg/m2).Intensive therapy with insulin analogues was used in 121 (78.6%), and 33patients (21.4%) were treated via insulin pumps. We did not observedelayed puberty.

We have found hepatomegaly in 9.7% patients, elevatedtransaminases in 18.8%, ultrasound-enlarged liver in 21.7% and27.3% with abnormal echogenicity. MRI and liver biopsy were performed in9 patients. A liver biopsy revealed 8 patients with glycogenic hepatopathy andonly one with non-alcoholic fatty liver disease. MRI showed a good associationwith pathohistological findings (P < 0.001). We did not establish a correlationbetween hepatic complications and chronic complications or associated autoimmunediseases.

Conclusion

Liver disorders in patients with T1DM are not as rare as previouslythought, and glycogenic hepatopathy is the most common. A combination of liverenzymes and a liver ultrasound exam is a good initial screening and follow-upmethod for the evaluation of liver disorders. MRI represents a good non-invasivetool for the distinction between glycogen and fat accumulation, and mightpostpone liver biopsy beyond initial workup.