title: Screening for non-alcoholic fatty liver disease in children and adolescents with type 1 diabetes mellitus: a cross-sectional analysis.
abstract: The liver is intensely involved in glucose metabolism and is thereby closely related to diabetes pathophysiology. Adult patients with type 1 diabetes mellitus (DM) are at an increased risk for non-alcoholic fatty liver disease (NAFLD). Here, we studied the prevalence of NAFLD in a cohort of children and adolescents with type 1 DM in a tertiary care paediatric diabetes centre in Germany. We screened 93 children and adolescents with type 1 DM using ultrasound, laboratory investigations, and liver stiffness measurements (Fibroscan® [FS] and acoustic radiation force imaging [ARFI]). Of these, 82 (88.1%) had completely normal results in all examined aspects. Only one patient (1.1%) fulfilled the criteria as potential NAFLD with ALT > twice the upper limit of normal. Ten of the 93 patients (10.8%) showed any mild abnormality in at least one examined category including ALT, conventional ultrasounds and liver stiffness measurements. However, none of these ten fulfilled the NAFLD case definition criteria. Therefore, these slightly abnormal results were judged to be unspecific or at least of unknown significance in terms of NAFLD indication.
  
  
  CONCLUSIONS
  Compared to data from the general population, our results do not indicate a significantly increased prevalence of NAFLD in this cohort, and advocate against the systematic screening for NAFLD in paediatric type 1 DM. What is Known: • Non-alcoholic fatty liver disease (NAFLD) is common in adults with type 1 DM, and paediatric patients with type 1 DM in Egypt and Saudi Arabia. What is New: • Our results do not indicate a significantly increased prevalence of NAFLD in a cohort of children and adolescents with type 1 DM from Germany compared to prevalence data from the general population. • This finding advocates against the systematic screening for NAFLD in paediatric type 1 DM in western countries.
authors.affiliation: Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Moorenstr. 5, 40225, Duesseldorf, Germany. Sebastian.kummer@med.uni-duesseldorf.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kummer
authors.affiliation: Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital, Moorenstr. 5, 40225, Dusseldorf, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Klee
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital, Moorenstr. 5, 40225, Duesseldorf, Germany.
authors.forename: Gerald
authors.initials: G
authors.lastname: Kircheis
authors.affiliation: Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Moorenstr. 5, 40225, Duesseldorf, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Friedt
authors.affiliation: Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital, Moorenstr. 5, 40225, Dusseldorf, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Schaper
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital, Moorenstr. 5, 40225, Duesseldorf, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Häussinger
authors.affiliation: Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Moorenstr. 5, 40225, Duesseldorf, Germany.
authors.forename: Ertan
authors.initials: E
authors.lastname: Mayatepek
authors.affiliation: Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Moorenstr. 5, 40225, Duesseldorf, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Meissner
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008403:Mass Screening; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014463:Ultrasonography
keywords: Diabetes complication; Diabetes mellitus type 1; Non-alcoholic fatty liver disease; Prevalence