Objectives To investigate the utility of shear wave elastography (SWE) in detecting morphologic abnormalities of the median nerve and posterior tibial nerve in transverse and longitudinal axes in adolescents with type 1 diabetes mellitus (DM) without diabetic peripheral neuropathy (DPN). Methods The median nerves and posterior tibial nerves of 25 adolescents with diagnosis and follow‐up of type 1 DM without DPN and 32 healthy volunteers were evaluated with SWE by 2 observers on the transverse and longitudinal axes. The cross‐sectional area and thickness of the nerves and disease duration were noted, and probable associations of these parameters with SWE features were analyzed. Interobserver and intraobserver correlations were also examined. The statistical significance level was set at P < .05. Results Both the median nerve and posterior tibial nerve were smaller, thinner, and stiffer in the patient group for both observers on both axes. The disease duration weakly correlated with median nerve SWE features (r = 0.245–0391). The thickness and cross‐sectional area had no correlations with SWE features. Conclusions The median nerve and posterior tibial nerve in adolescents with type 1 DM without DPN have morphologic abnormalities that can be displayed by SWE regardless of the imaging axis. Shear wave elastography may have a potential role in subclinical DPN, but the reliability of the findings is not as high as desirable.
We aimed to investigate the prevalence of cardiometabolic (CM) risk factors (impaired fasting glucose (>100 mg/dL), high blood pressure, overweight or obesity, high serum triglycerides (TG) and low serum high-density lipoprotein cholesterol levels) in children with hepatosteatosis detected by abdominal ultrasound. Children whom ultrasound examination revealed hepatic steatosis were included in the study. Medical records, anthropometric and biochemical parameters were reviewed for the presence of the CM risk factors. Presence of ≥3 risk factors was defined as metabolic syndrome (MS).One hundred and forty-eight children and adolescents (67 boys, 81girls, and mean age 12.1±2.7 years) with hepatosteatosis were included. Sonographic hepatosteatosis grades of 1, 2 and 3 were observed in 111 (75%), 33 (22.3%), and 4 (2.7%) subjects, respectively. MS was observed in 36 patients (24.3%). The number of CM risk factors and degree of hepatic steatosis were correlated (r=0.183, p=0.026). Serum TG levels in girls and age in boys were significantly associated with the presence of medium to severe hepatosteatosis (grades 2 or 3) (R 2 =.342, =.040 and R 2 =.538, p=.001, respectively). CM risk factors and MS are common in children with hepatosteatosis. The presence and grade of hepatosteatosis on ultrasound can be used as surrogate markers of MS and CM risk in children.
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