Endocrine Abstracts

JOINT578

Aims: To evaluate the prevalence of liver steatosis, fibrosis, and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in children and adolescents with type 1 diabetes using transient elastography, and to identify associated clinical variables.

Material and Methods: Cross-sectional study including 192 children and adolescents aged 6–18 years with type 1 diabetes for at least 12 months, recruited from Pediatric Diabetes Departments across Eastern Denmark between May 2022 and June 2024. Transient elastography was used to measure controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) to assess steatosis and fibrosis, respectively. MASLD was defined as the presence of steatosis or fibrosis in addition to at least one metabolic risk factor, such as overweight/obesity, insulin resistance, impaired glucose tolerance, low HDL cholesterol, elevated blood pressure, or high triglycerides. Moreover, alanine aminotransferase and aspartate aminotransferase levels were measured, and screening for celiac disease was performed.

Results: The prevalence of steatosis (CAP > 90th percentile) was 2%, fibrosis (LSM > 90th percentile) was 8%, and MASLD was 4%. Higher CAP values were associated with higher BMI z-scores (P = 0. 012) and lower glucose time-in-range (P = 0. 029). Fibrosis was more prevalent in males (P = 0. 0003). None of the participants with steatosis, fibrosis or MASLD had elevated alanine aminotransferase and aspartate aminotransferase levels or celiac disease.

Conclusion: The prevalence of steatosis, fibrosis, and MASLD in children and adolescents with type 1 diabetes was low. Steatosis was associated with higher BMI and poorer glycemic control, while fibrosis was associated with male sex.