There are significant associations between liver biomarkers and disease severity in patients with type 2 diabetes (T2D), according to study results published in Obesity Medicine.

To determine whether a relationship exists between abnormal serum hepatic enzymes, lipid levels, and glycemic control in T2D, researchers conducted a cross-sectional study of 453 patients with T2D (mean age, 54.47 years) from a private healthcare center. The researchers collected sociodemographic, clinical, and laboratory data for each patient from medical records.

Of the total population, 80.8% had abnormal levels of one of the tested hepatic enzymes (alanine transaminase [ALT], aspartate transaminase [AST], and albumin), 6.4% had 2 abnormal parameters, and 2.4% had >2 abnormal parameters. On an individual level, 13.9% had abnormal ALT levels, 3.8% had abnormal AST levels, and 84.5% had abnormal albumin levels. There were no significant differences in abnormal serum hepatic enzymes between men and women.

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Using statistical modeling, the researchers found that all 3 mean hepatic enzyme levels were jointly and significantly associated with poorly controlled T2D (hemoglobin A1c [HbA1c] ≥7%): an albumin increase of 1 g/dL yielded a 52.7% decrease in risk for poor glycemic control, and an ALT or AST increase of 10 U/L yielded a 36% and 53% increase for HbA1c ≥7% (P <.001 and P =.001, respectively).

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Furthermore, lipid profiles were also significantly associated with abnormal hepatic levels. Odds of having abnormal ALT were significantly higher with incremental increases in body mass index, HbA1c, triglycerides, and total cholesterol levels. Odds of having abnormal AST were significantly higher with increases in HbA1c and lower with increases in total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels. Odds of having abnormal hepatic albumin correlated to increases in body mass index, while increases in high-density lipoprotein cholesterol and triglyceride levels were associated with lower odds of having abnormal albumin.

The researchers concluded that their findings “demonstrated that high ALT is characteristic of [patients with T2D]…pointing to the fact that the development of hepatic anomalies with poor glycemic control attendants could indicate unfavorable evolution of [T2D].”

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Shahwan MJ, Khattab AH, Khattab MH, Jairoun AA. Association between abnormal serum hepatic enzymes, lipid Levels and glycemic control in patients with type 2 diabetes mellitus. Obesity Med. 2019;16:100137.