Glycogenic hepatopathy associated with hepatic steatosis in type 1 diabetes

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications Pub Date : 2024-09-17 DOI:10.1016/j.jdiacomp.2024.108870

Stephanie Teasdale , Xin Dong , Alison Griffin , Paul James Clark , Janelle Nisbet , Adam Morton , Liza Phillips , Mitchell Anthony Sullivan , Graham Galloway

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引用次数: 0

Abstract

Aims

Glycogenic hepatopathy is associated with significant psychosocial consequences and health costs. Metabolic Dysfunction-Associated Steatotic Liver Disease and glycogenic hepatopathy are frequently confused as “fatty liver” when seen on ultrasonography. We wished to examine liver fat and glycogen content in groups defined based on metabolic and liver disease phenotypes.

Methods

This case-control study undertaken in a tertiary hospital used nuclear proton magnetic resonance spectroscopy (¹H-MRS) to examine liver fat and glycogen content in five clinical groups, each containing five participants: 1. type 1 diabetes with glycogenic hepatopathy, 2. satisfactorily controlled type 1 diabetes with no liver disease, 3. poorly controlled type 1 diabetes without liver disease, 4. a control group of body mass index- and age-matched individuals without diabetes or liver disease, and 5. hepatic steatosis.

Results

Fat content was highest in the hepatic steatosis (median 15.4 %, IQR 10.0–19.3) and glycogenic hepatopathy (median 6.5 %, IQR 4.5–9.1) groups and compared to both of these groups was lower in the control group (median 1.0 %, IQR 0.7–1.1, p 0.002 and 0.022), the T1DM group with satisfactory control (median 0.3 %, IQR 0.2–0.6, p < 0.001 and <0.001), and the T1DM group with poor control without liver disease (median 1.1 %, IQR 0.9–1.1, p 0.001 and 0.012).

No participants from the type 1 diabetes poor control, type 1 diabetes satisfactory control or the no diabetes groups had ¹H-MRS-diagnosed hepatic steatosis.

¹H-MRS glycogen content could not be interpreted in the majority of those with glycogenic hepatopathy because of interference from the fat signal.

Conclusions

In cases diagnosed with glycogenic hepatopathy there may be significant concomitant fat accumulation, compounding the already elevated cardiovascular risk in this cohort.

The technique of ¹H-MRS has not been demonstrated to be useful for diagnosing glycogenic hepatopathy.

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与 1 型糖尿病肝脂肪变性相关的糖源性肝病

目的糖原性肝炎与严重的社会心理后果和健康成本相关。在超声波检查中，代谢功能障碍相关性脂肪肝和糖原性肝炎经常被混淆为 "脂肪肝"。我们希望对根据代谢和肝病表型定义的组别中的肝脏脂肪和糖原含量进行检查。方法这项病例对照研究在一家三甲医院进行，使用核质子磁共振波谱（1H-MRS）对五个临床组别中的肝脏脂肪和糖原含量进行检查，每个组别包含五名参与者：结果肝脂肪变性组（中位数为 15.4%，IQR 为 10.0-19.3）和糖原性肝炎组（中位数为 6.5%，IQR 为 4.5-9.1）的脂肪含量最高。1）组和这两组相比，对照组（中位数 1.0 %，IQR 0.7-1.1，P 0.002 和 0.022）、控制满意的 T1DM 组（中位数 0.3 %，IQR 0.2-0.6，P < 0.001 和 < 0.1型糖尿病控制不佳组、1型糖尿病控制满意组或无糖尿病组的参与者均未出现 1H-MRS 诊断的肝脏脂肪变性。由于脂肪信号的干扰，大多数糖原性肝炎患者的 1H-MRS 糖原含量无法解读。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.