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ISSN: 0031-3939
Pediatria Polska - Polish Journal of Paediatrics
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3/2020
vol. 95
 
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abstract:
Original paper

The role of serum cytokeratin 18 and platelet count as non-invasive markers in the diagnosis of nonalcoholic fatty liver disease in children with type 1 diabetes mellitus

Nagwa A. Ismail
1
,
Abeer M. N. E. Abd ElBaky
1
,
Mona H. Ibrahim
2
,
Wafaa Mohamed Ezzat
3
,
Yasser A. Elhosary
3
,
Eman A. Mostafa
1
,
Hoda H. Ahmed
1
,
Inas Abdel Rasheed
2

  1. Department of Paediatrics, Medical Research Division, National Research Centre, Cairo, Egypt
  2. Department of Clinical Pathology, Medical Research Division, National Research Centre, Cairo, Egypt
  3. Department of Internal Medicine, National Research Centre, Cairo, Egypt
Pediatr Pol 2020; 95 (3): 141–148
DOI: https://doi.org/10.5114/polp.2020.100990
Online publish date: 2020/10/30
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Introduction
Nonalcoholic fatty liver disease (NAFLD) is the commonest chronic hepatopathy in children and adults.

Aim of the study
To evaluate the role of cytokeratin 18 (CK-18) and platelet count as non-invasive markers in the diagnosis of nonalcoholic fatty liver disease in children with type 1 diabetes mellitus (T1DM).

Material and methods
The study included 71 T1DM patients with age range 6–18 years old and 48 healthy age- and sex-matched volunteers. The T1DM patients were divided into NAFLD(+) (n = 12) and NAFLD(–) (n = 40) groups. Blood samples were collected for assessment of complete blood count, complete lipid profile, glycosylated haemoglobin, liver enzymes, and serum CK-18. Ultrasonography distinctively quantifies visceral fat and subcutaneous fat, ultrasound evaluation of hepatic steatosis, and liver size. Acoustic radiation force impulse elastography was used to evaluate liver fibrosis.

Results
The mean serum cholesterol, triglyceride, and LDL-cholesterol were statistically significantly higher in cases with NAFLD compared to cases without NAFLD and controls (p = 0.033, p = 0.001, p = 0.023, respectively). Comparing with the controls, cases exhibited significantly higher values for platelets count (p < 0.005). Regarding the mean level of serum CK-18, it was 168.88 ±96.462 mIU/ml in patients without NAFLD vs. 173.29 ±101.95 mIU/ml in patients with NAFLD and 140.75 ±79.97 mIU/ml in controls. Interestingly, the observed positive correlation between serum CK-18 and platelets counts in diabetic patients was statistically significant (r = 0.230, p = 0.046). Platelets count and visceral fat thickness were statistically significantly predictors of NAFLD. Significantly higher serum CK-18 in cases with NAFLD and liver fibrosis compared with those without liver fibrosis evaluated by acoustic radiation force impulse elastography.

Conclusions
CK-18 and platelet count may be useful markers for predicting liver fibrosis and help in the follow-up regimen of NAFLD in cases with T1DM.

keywords:

cytokeratin 18, platelets count, nonalcoholic fatty liver disease, liver fibrosis, type1 diabetes mellitus