Background: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children. NAFLD has become increasingly recognized in pediatric populations with type 1 diabetes (T1D) . Also, NAFLD is emerging as an independent risk factor for cardiovascular disease (CVD) . Arterial stiffness is an index of subclinical atherosclerosis and can predict cardiovascular events and mortality.

Objectives: The aim of this pilot study was to estimate the prevalence of NAFLD in children with T1D and to examine the relationship between NAFLD and arterial stiffness.

Subjects and Methods: A cross-sectional pilot study of 18 children (age 7-20 years) with a diagnosis of T1D for at least 5 years without secondary causes of chronic liver disease. The main study measures included: 1. Detection of fatty liver in children with T1D measured by controlled attenuation parameter (CAP) using FibroScan and 2. Measurement of arterial stiffness by pulse wave velocity (PWV) using SphygmoCor. We also aimed to measure hepatic fibrosis by FibroScan and insulin sensitivity (IS) by using a validated surrogate marker.

Results: The prevalence of NAFLD was approximately 19% of study participants. We found positive correlations between CAP and PWV values, which suggests higher arterial stiffness with higher degree of fatty liver. Median PWV was higher in participants with steatosis compared to those without steatosis, 6.vs. 6.5 m/s. We also found negative correlations between IS and both arterial stiffness and steatosis (R=-0.56, p=0.038) , (R=-0.56, p=0.063) , respectively.

Conclusions: Our findings suggest that NAFLD is common in participants with T1D and in this study was associated with higher arterial stiffness. Our study is consistent with previously reported associations between decreased IS and presence of microvascular complications. Larger randomized controlled trials are required to evaluate whether NAFLD predicts the incidence of CVD events in T1D.


R.Zeiad: None. M.Crespo: None. J.R.Wood: Research Support; AstraZeneca, Boehringer Ingelheim International GmbH, Insulet Corporation, MannKind Corporation. R.M.Farrell: Stock/Shareholder; Dexcom, Inc., Tandem Diabetes Care, Inc.


18117-FRAP 2020-21

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