Features of the Liver Sonoelastography Findings in Patients with Type 1 Diabetes Mellitus in Childhood

Abstract

Introduction: The prevalence and association of type 1 diabetes mellitus (T1D) and non-alcoholic fatty liver disease (NAFLD) have been explored; however, no study has examined liver parenchyma elasticity in pediatric T1D patients without NAFLD. Two-dimensional shear wave sonoelastography (2D-SWE) can effectively detect and grade fibrosis in liver diseases that can be seen in T1D patients. The aim of this study was to analyze the 2D-SWE results of the liver in T1D children without NAFLD to identify any potential effects early. Methods: This prospective case-control study included 53 T1D patients (11.4±3.2 years) and 50 healthy children [12.5 (6) years]. None of the individuals were obese. Both groups had normal grayscale echogenicity, lipid profiles, and liver enzyme levels, ruling out NAFLD. The mean elasticity value was calculated as kiloPascal (kPa) by measuring in the right lobe of the liver. Correlations between elasticity and aspartate aminotransferase (AST), alanine aminotransferase, fasting blood glucose (FBG), duration of diabetes mellitus, and hemoglobin A1c (HbA1c) were evaluated and compared. P0.05). Conclusion: Although liver function tests, lipid profiles, and grayscale ultrasonography showed no abnormalities in our pediatric T1D patients, increased liver parenchymal stiffness detected by 2D-SWE compared with the healthy group indicated hepatic involvement. Therefore, 2D-SWE follow-up may help detect liver involvement and NAFLD before grayscale and laboratory findings arise. Long-term follow-up studies involving a larger population of T1D patients would be beneficial in establishing quantitative reference values for 2D-SWE and will enhance the literature on this topic.

Keywords

• shear wave elastography
• type 1 diabetes mellitus
• liver
• nafld
• pediatric