Tag Archives: hyperglycemia

Liver Briefs: MASLD with T1DM, ESPGHAN Pediatric HCV Recommendations, Age of Kasai in Europe

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  1. F Koutny et al. JPGN 2024; https://doi.org/10.1002/jpn3.12194. Open Access! Poorly controlled pediatric type 1 diabetes mellitus is a risk factor for metabolic dysfunction associated steatotic liver disease (MASLD): An observational study

Study population, n=32,325. Key finding:  Inadequately controlled T1D (HgbA1c >11%) was associated with a higher hazard ratio ((HR: 1.54) of elevated ALT values compared to children with controlled T1D over an observation period extending up to 5.5 years. When both elevated HbA1c (>11%) and overweight were present, the HR was 2.71.

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2. G Indolfi et al. JPGN 2024; 78:957–972. ESPGHAN recommendations on treatment of chronic hepatitis C virus infection in adolescents and children including those living in resource-limited settings

Summary of Recommendations:

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3. F Lacaille et al. JPGN 2024; 78:1374–1382. Awareness, referral and age at Kasai surgery for biliary atresia in Europe: A survey of the Quality-of-Care Task Force of ESPGHAN

Key finding: Data from 785 infants diagnosed with BA from 2015 to 2019 from 18 centers in 15 countries revealed a mean age at referral to tertiary center of 55 days (similar to results obtained in Europe 10–30 years earlier)

Related blog posts:

Biliary Atresia

HCV:

Is Cognition Affected by Obesity/Metabolic Disease?

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A recent provocative study : “Childhood Metabolic Biomarkers Are Associated with Performance on Cognitive Tasks in Young Children” ALB Shapiro et al. J Pediatr 2019; 211: 92-7

Methods: Data were obtained from children (n=137, 4.6 years old on average) participating in the Healthy Start study, a pre-birth cohort in Colorado. This included metabolic markers (HOMA-IR, glucose, insulin) and cognitive performance markers (Flanker task, Dimensional Change Card Sort test (which assesses cognitive flexibility), and Picture Vocabulary test).

Key findings:

  • HOMA-IR, glucose, and insulin were all inversely significantly-associated with cognitive flexibility testing. Thus, the authors found that “greater blood biomarkers of poor metabolic health are related to lower cognitive flexibility and inhibitory control in healthy, young children.”

Discussion:

  • The authors note that their findings “contribute to the large body of literature in children with overt type 1 and type 2 diabetes that demonstrates consistent and negative effects of poor metabolic health on cognition.”
  • The metabolic effects on cognition may be more critical in childhood due to brain maturation as well as potential for longer exposure periods.  However, studies from adults indicate that “adults without overt diabetes, the cumulative burden of metabolic conditions (eg. obesity, hyperglycemia) was significantly associated with lower cognitive scores.”

My take: While the effects of metabolic disease on cardiovascular disease is well-recognized, this study adds to the body of knowledge that indicates the potential harm of metabolic disease on the brain as well.

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