title: Transient elastography as a noninvasive assessment tool for hepatopathies of different etiology in pediatric type 1 diabetes mellitus.
abstract: To identify the prevalence and effect of hepatopathies of different etiologies among pediatric patients with type 1 diabetes mellitus (T1DM) using transient elastography (TE) and its relation to glycemic control.
  
  
  
  One hundred T1DM patients were studied focusing on liver functions, fasting lipid profile, hemoglobin A1c (HbA1c), hepatitis C virus (HCV), serum immunoglobulins, autoimmune antibodies; anti-nuclear antibody (ANA), anti-smooth muscle antibody (ASMA), and anti-liver kidney microsomal antibody (anti-LKM). Abdominal ultrasound was performed and TE was done for patients with HCV, positive autoimmune antibody and/or abnormal ultrasound findings.
  
  
  
  Thirty-one patients were found to have one or more hepatic abnormalities; clinical hepatomegaly in 8%, elevated alanine aminotransferase (ALT) in 10%, HCV in 6%, autoimmune hepatitis (AIH) in 11% (10 were positive for ASMA and 2 were positive for ANA while anti-LKM antibodies were negative) and abnormal hepatic ultrasound in 20% (12 non-alcoholic fatty liver disease, 5 AIH, 2 HCV, 1 Mauriac syndrome). Mean liver stiffness in those 31 patients was 7.0±2.1kPa (range, 3.1-11.8kPa); 24 were Metavir F0-F1, 7 were F2-F3 while none was F4. Type 1 diabetic patients with abnormal hepatic ultrasound had higher fasting blood glucose, HbA1c and total cholesterol than those with normal findings. Liver stiffness was significantly higher in patients with abnormal liver ultrasound compared with normal sonography. Liver stiffness was positively correlated to HbA1c and ALT.
  
  
  
  Hepatic abnormalities are prevalent in T1DM and related to poor metabolic control. TE provides a non-invasive method for detection of hepatopathy-induced fibrosis.
authors.affiliation: Department of Pediatrics, Faculty of medicine, Ain shams University, Cairo, Egypt.
authors.forename: Zeinab A
authors.initials: ZA
authors.lastname: Elkabbany
authors.affiliation: Department of Pediatrics, Faculty of medicine, Ain shams University, Cairo, Egypt. Electronic address: nancy_elbarbary@yahoo.com.
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Elbarbary
authors.affiliation: Department of Clinical Pathology, Faculty of medicine, Ain shams University, Cairo, Egypt.
authors.forename: Eman A
authors.initials: EA
authors.lastname: Ismail
authors.affiliation: Department of Clinical Pathology, Faculty of medicine, Ain shams University, Cairo, Egypt.
authors.forename: Nesrine A
authors.initials: NA
authors.lastname: Mohamed
authors.affiliation: Department of Clinical Pathology, Faculty of medicine, Ain shams University, Cairo, Egypt.
authors.forename: Dina
authors.initials: D
authors.lastname: Ragab
authors.affiliation: Department of Endemic medicine and Hepatology, Faculty of medicine, Cairo University, Cairo, Egypt.
authors.forename: Shereen
authors.initials: S
authors.lastname: Abdel Alem
authors.affiliation: Department of Pediatrics, Faculty of medicine, Ain shams University, Cairo, Egypt.
authors.forename: Yasmine M
authors.initials: YM
authors.lastname: Ezzat
authors.affiliation: Department of Pediatrics, Faculty of medicine, Ain shams University, Cairo, Egypt.
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Maurice
authors.affiliation: Department of Pediatrics, Faculty of medicine, Ain shams University, Cairo, Egypt.
authors.forename: Noha U
authors.initials: NU
authors.lastname: Hashem
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000628:therapy; D004534:Egypt / Q000453:epidemiology; D054459:Elasticity Imaging Techniques; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D016174:Hepacivirus / Q000302:isolation & purification; D048550:Hepatic Insufficiency / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D019693:Hepatitis, Autoimmune / Q000150:complications / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D006529:Hepatomegaly / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007003:Hypoglycemia / Q000517:prevention & control*; D015994:Incidence; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology; D008297:Male; D015995:Prevalence; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Autoimmune hepatitis; Hepatitis C; Liver stiffness; NAFLD; Transient elastography; Type 1 diabetes