Endocrine Abstracts

Introduction

Non alcoholic steato-hepatitis (NASH) is the most common chronic liver disease in developed countries rare in type 1 diabetes it is associated with an increased risk of complications in patients with type 1 diabetes mellitus (T1DM). The aim of this study is to clarify the characteristics of NASH in patients with T1DM.

Materials and methods

we conducted a retrospective descriptive study in non-alcoholic type 1 diabetes patients diagnosed with ultrasound of hepatic steatosis, hospitalized in the endocrinology department of the Hedi-Chaker University Hospital in Sfax between 2000 and 2020.

Results

8 medical records were analyzed, of which 6 women and 2 men, a sex ratio of 1 in 3, the average age was 27.25 years (16 -67 years), the average weight was 56.12 kg (41- 72 kg), with average BMI of 21.6 kg/m² (15- 28 kg/m²). One patient has overweight. The average waist circumference was 82.3 cm (65–111 cm), 4 patients had dyslipidemia, no history of hypertension, no atherosclerosis was found. Only 2 patients had metabolic syndrome. History of: T2DM in 5 patients, android obesity in 1 single patient and dyslipidemia in 1 other patient, no family history of T1DM neither autoimmune pathologywas found. The metabolic assessment of our patients was as follows: the mean blood glucose level was 18.7 mmol/l (10.9–32), the mean HBA1c rate was 11.6% (7–14), the average creatinine rate of 66.4 µmol/l (41–117), with an average GFR of 130 ml/min (57–231). The average lipid level: total cholesterol: 5.7 mmol/l, triglycerides: 2.03 mmol/l, HDL: 1.25 mmol/l, LDL: 2.4 mmol/l. Thehepaticassessment was:meanASAT rate was 422 Iu/l (22-1430), the mean ALAT rate was 245.7 Iu/l (17-1420). The hepatic steatosis index measured was an average of 30.5 (23–40.7). The total daily insulin dose averaged 64.3 IU (20–106), equivalent of 1.14 IU/Kg (0.44–1.56), 5 patients receive insulin doses greater than 1 IU/kg per day. 2 patients were under mixed treatment (metformin + insulin). Diabetes duration average was 10 years (4–19). The duration of onset of NASH compared to the diagnosis of diabetes was on average 7 years (1–16). Degenerative complications related to diabetes were as follows: 2 patients had retinopathy, 2 patients had neuropathy and only one had nephropathy.

Conclusion

NASH should be researched and well monitored in type 1 diabetics especially in view of android obesity and high transaminase rate; the diagnosis of this liver disease should lead to the achievement of a metabolic and cardiovascular assessment.