PMID- 35663787
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2352-6467 (Electronic)
IS  - 2352-6467 (Linking)
VI  - 9
IP  - 2
DP  - 2022 Jun
TI  - Treatment of hyperglycemia not associated with NAFLD improvement in children with 
      type 2 diabetes mellitus.
PG  - 83-88
LID - 10.1016/j.ijpam.2021.02.007 [doi]
AB  - BACKGROUND AND OBJECTIVES: Nonalcoholic fatty liver disease (NAFLD) and type 2 
      diabetes mellitus (T2DM) have become public health problems in the pediatric 
      population. However, the relationship between these two conditions is not well 
      understood. The primary objective of this study was to assess whether treatment 
      of hyperglycemia in obese, treatment-naive children with type 2 diabetes (T2DM) 
      was associated with an improvement of surrogate markers of NAFLD. MATERIALS AND 
      METHODS: This retrospective, longitudinal study included 151 obese children with 
      a diagnosis of T2DM (Age: 14 +/- 1 years, 72% female children, BMI: 98.6th 
      percentile, and A1c: 10.3 +/- 0.2%). Clinical/demographic information was collected 
      before patients started any diabetes treatment and 1 and 3 years after starting 
      metformin and/or insulin therapy. RESULTS: Forty-eight patients (32%) had 
      abnormal ALT/AST (i.e., >40 U/L), suggestive of NAFLD. After 1 year of therapy, 
      there were no significant differences in plasma ALT among patients started on 
      insulin, metformin, or combination: 5+/-4 vs. -10 +/- 3 vs. -2+/-2 IU/L, respectively, 
      P = .07. Of note, changes in plasma ALT were small, despite a significant 
      reduction of A1c in patients prescribed insulin (alone or with metformin): 
      -2.8 +/- 1.0%, P = .01, and -2.7 +/- 0.3%, P < .001, respectively. In line with this, 
      no significant correlations were found between changes in A1c and plasma 
      aminotransferases. In contrast, changes in plasma AST/ALT were more strongly 
      associated with BMI changes (r = 0.32, P < .001, and r = 0.19, P = .04, 
      respectively). Similar results were observed after 3 years of follow-up. 
      CONCLUSIONS: Nonalcoholic fatty liver disease is highly prevalent in obese 
      children with T2DM. Treatment of hyperglycemia with metformin and/or insulin did 
      not result in any significant improvement in surrogate markers of NAFLD (i.e., 
      plasma aminotransferases). While changes in ALT and/or AST may not perfectly 
      reflect histological changes in NAFLD, our findings suggest that the treatment of 
      hyperglycemia per se may not be associated with NAFLD improvement.
CI  - (c) 2021 Publishing services provided by Elsevier B.V. on behalf of King Faisal 
      Specialist Hospital & Research Centre (General Organization), Saudi Arabia.
FAU - Beauchamp, Giovanna
AU  - Beauchamp G
AD  - Division of Pediatric Endocrinology, University of Alabama at Birmingham, 
      Birmingham, AL, USA.
FAU - Barr, Mary M
AU  - Barr MM
AD  - Division of Pediatric Endocrinology, University of Alabama at Birmingham, 
      Birmingham, AL, USA.
FAU - Vergara, Ariana
AU  - Vergara A
AD  - Division of Endocrinology, Diabetes and Metabolism, University of Florida, 
      Gainesville, FL, USA.
FAU - Ashraf, Ambika
AU  - Ashraf A
AD  - Division of Pediatric Endocrinology, University of Alabama at Birmingham, 
      Birmingham, AL, USA.
FAU - Bril, Fernando
AU  - Bril F
AD  - Division of Endocrinology, Diabetes and Metabolism, University of Florida, 
      Gainesville, FL, USA.
AD  - Internal Medicine, Department of Medicine, University of Alabama at Birmingham, 
      Birmingham, AL, USA.
LA  - eng
PT  - Journal Article
DEP - 20210303
PL  - Netherlands
TA  - Int J Pediatr Adolesc Med
JT  - International journal of pediatrics & adolescent medicine
JID - 101670718
PMC - PMC9152559
OTO - NOTNLM
OT  - Fatty liver
OT  - Insulin resistance
OT  - Insulin therapy
OT  - Metformin
OT  - Steatosis
EDAT- 2022/06/07 06:00
MHDA- 2022/06/07 06:01
PMCR- 2021/03/03
CRDT- 2022/06/06 14:05
PHST- 2020/09/22 00:00 [received]
PHST- 2020/12/16 00:00 [revised]
PHST- 2021/02/23 00:00 [accepted]
PHST- 2022/06/06 14:05 [entrez]
PHST- 2022/06/07 06:00 [pubmed]
PHST- 2022/06/07 06:01 [medline]
PHST- 2021/03/03 00:00 [pmc-release]
AID - S2352-6467(21)00024-7 [pii]
AID - 10.1016/j.ijpam.2021.02.007 [doi]
PST - ppublish
SO  - Int J Pediatr Adolesc Med. 2022 Jun;9(2):83-88. doi: 10.1016/j.ijpam.2021.02.007. 
      Epub 2021 Mar 3.