Type 1 Diabetes Mellitus And Metabolic Dysfunction–Associated Steatotic Liver Disease In Children And Adolescents: A Cross-Sectional Study

Objective: This study aimed to determine the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) in children and adolescents with type 1 diabetes mellitus (T1DM) using vibration-controlled transient elastography (VCTE), and to evaluate associated clinical and laboratory features. Methods: This cross-sectional study included 72 children with T1DM and 83 healthy controls who were comparable in age and sex. Hepatic steatosis was assessed using ultrasonography and VCTE. A controlled attenuation parameter (CAP) value >236 dB/m was used to define CAP-based hepatic steatosis/MASLD in the T1DM group. Clinical, anthropometric, laboratory, and radiological characteristics were compared between groups. Correlations of CAP and liver stiffness measurement (LSM) with clinical and laboratory parameters were evaluated in the T1DM cohort. Stepwise multivariable linear regression analyses were performed to identify candidate factors independently associated with CAP and LSM values. Results: CAP-based hepatic steatosis/MASLD was more frequent in children with T1DM than in controls (31.9% vs. 14.5%). Among children with T1DM, those with MASLD had higher body mass index, WHtR, diastolic blood pressure, and triglyceride levels than those without MASLD. In the multivariable CAP model, diabetes duration, low-density lipoprotein cholesterol, and WHtR were independently associated with higher CAP values. WHtR and alanine aminotransferase were independently associated with higher LSM values. Conclusion: Children and adolescents with T1DM had a higher prevalence of CAP-based hepatic steatosis/MASLD than healthy controls. Adiposity-related parameters and dyslipidemia appear to be important clinical features associated with hepatic steatosis in pediatric T1DM.