Abstract / Summary
To evaluate the associations of the growth hormone (GH) and insulin-like growth factor (IGF-1) axis on linear growth and metabolically associated fatty liver disease (MASLD) risk in children with type 1 diabetes mellitus (T1DM). This single-center cross-sectional study included 250 children with T1DM. Assessments included anthropometric measurements, GH, IGF-1, and hemoglobin A1c (HbA1c) levels, and liver ultrasonography for MASLD screening. Multivariate logistic and linear regression models were used for analysis. The cohort’s mean HbA1c was 10.8 ± 0.2%. MASLD was diagnosed in 36% of children, and age-adjusted IGF-1 levels were reduced in 60% of participants. Significant predictors of MASLD included disease duration (odds ratio [OR] = 1.180), HbA1c levels (OR = 1.146), and alanine aminotransferase (OR = 1.028). Notably, the presence of MASLD significantly increased the risk of reduced IGF-1 levels (relative risk = 1.841, 95% confidence interval: 1.113–3.044). Although IGF-1 initially correlated with height, the association lost significance after adjusting for age and sex, whereas disease duration remained a strong negative predictor for linear growth ( p = 0.000). Poor glycemic control and longer disease duration were the major factors associated with MASLD in children with T1DM. The association between MASLD and the dysregulation of the GH/IGF-1 axis indicates significant hormonal dysregulation linked to insulin deficiency and metabolic decompensation. Not applicable.