Official publication of Rawalpindi Medical University
Comparison Of ALT In Type 2 Diabetics with And Without Fatty Liver Disease

Supplementary Files

PDF

How to Cite

1.
Malik K, Batool F, Meraj L, Saddiq S, Akbar A, Mughal HH. Comparison Of ALT In Type 2 Diabetics with And Without Fatty Liver Disease. JRMC [Internet]. 2023 Jun. 24 [cited 2024 Apr. 22];27(2). Available from: https://journalrmc.com/index.php/JRMC/article/view/2049

Abstract

Objective: To determine the association of alanine aminotransferase in type 2 diabetic patients with and without fatty liver disease.

Materials and Methods: A cross-sectional study was done for six months at Sheikh Khalifa Bin Zaid Al-Nahyan Hospital Rawalakot. In our study, we included all the patients who presented to the outpatient department (OPD) having type 2 diabetes mellitus. Their age, gender, height, weight, and duration of diabetes mellitus were noted. Their liver function test (LFTS), fasting blood sugar and HBA1c, and fasting lipid profile were also done at the time of their OPD visit and results were noted. They were given an appointment for an ultrasound abdomen from the radiology department for detection of fatty liver disease and the results were noted on the next OPD visit.

Results: Total study population was 90 patients and out of which 35 (38.8%) were male and 55 (61.1%) were female. 58 years was the mean age of our study population. Fatty liver was present in 50% of patients. ALT was raised from a baseline value of 36 in 61% of patients while fasting blood sugar was raised in 83% of patients. The mean fasting blood sugar was 208 mg/dl. ALT was not significantly different in patients with and without fatty liver disease. However, it was found that patients with uncontrolled blood glucose levels have significantly raised ALT which was also statistically proven as the P value was less than 0.05. Also, patients with high blood glucose have a higher incidence of fatty liver disease as compared with normal blood glucose level patients but the difference was not statistically significant as shown by a P value more than 0.05.

Conclusion: Fatty liver disease is more common in Type 2 diabetic patients with uncontrolled blood sugar. There is a high rate of raised ALT in diabetic patients whose blood sugar control is not optimum.

https://doi.org/10.37939/jrmc.v27i2.2049

References

Mandal A, Bhattarai B, Kafle P, Khalid M, Jonnadula SK, Lamicchane J, et al. Elevated Liver Enzymes in Patients with Type 2 Diabetes Mellitus and Non-alcoholic Fatty Liver Disease. Cureus. 2018 Nov; 10(11): e3626. Published online 2018 Nov 23. doi: 10.7759/curious.3626

Dharmalingam M and Yamasandhi PG. Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus. Indian J Endocrinol Metab. 2018 May-Jun; 22(3): 421–8. doi: 10.4103/ijem.IJEM 585 17

Williams CD, Stengel J, Asike MI, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology. 2011 Jan 1;140(1):124-31. https://doi.org/10.1053/j.gastro.2010.09.038

Amjad W, Malik A, Qureshi W, Dennis B, Mumtaz M, Haider R, Jamal S, Jaura F, Ahmed A. Sodium-glucose cotransporter-2 inhibitors improve liver enzymes in patients with co-existing non-alcoholic fatty liver disease: a systematic review and metanalysis. Gastroenterology Review/Przegląd Gastroenterologiczny. 2022 Jan 5;17(4):288-300.

https://doi.org/10.5114/pg.2021.112365

Tesfay M, Goldkamp WJ, Neuschwander-Tetri BA. NASH: the emerging most common form of chronic liver disease. Missouri medicine. 2018 May;115(3):225-29. PMID: 30228727; PMCID: PMC6140162

Loomba R, Sanyal AJ. The global NAFLD epidemic. Nature Reviews Gastroenterology & hepatology. 2013 Nov;10(11):686-90. https://www.nature.com/articles/nrgastro.2013.171

Mofrad P, Contos MJ, Haque M, et al. Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatology. 2003 Jun;37(6):1286-92

https://doi.org/10.1053/jhep.2003.50229

Goel A, Jones J, Di Muzio B, et al. Diffuse hepatic steatosis (grading). Reference article, Radiopaedia.org (Accessed on 23 Mar 2023). https://doi.org/10.53347/rID-33279

Saligram S, Williams EJ, and Masding MG. Raised liver enzymes in newly diagnosed Type 2 diabetes are associated with weight and lipids, but not glycaemic control. Indian J Endocrinol Metab. 2012 Nov-Dec; 16(6): 1012–14.

doi: 10.4103/2230-8210.103027

Abro MUR, Butt A, Baqa K, Waris N, Khalid M, and Fawwad A. Association of serum liver enzyme Alanine Aminotransferase (ALT) in patients with type 2 diabetes. Pak J Med Sci. 2018 Jul-Aug; 34(4): 839–43.

doi: 10.12669/pjms.344.15206

Sanyal D, Ghosh S, Mukherjee P, Mukherjee S, Chowdhury S. Dyslipidemia, metabolic syndrome, and liver enzymes in impaired glucose tolerance and new onset untreated, type 2 diabetes Indian subjects. Indian J Endocrinol Metab. 2012 Dec; 16 (Suppl 2):S434-5.

doi: 10.4103/2230-8210.104121

Nannipieri M, Gonzales C, Baldi S, Posadas R, Williams K, Haffner SM et al. Liver enzymes, the metabolic syndrome, and incident diabetes: the Mexico City diabetes study. Diabetes care. 2005 Jul 1;28(7):1757-62.

https://doi.org/10.2337/diacare.28.7.1757

Sanyal D, Mukherjee P , Raychaudhuri M , Ghosh S , Mukherjee S , Chowdhury S. Profile of liver enzymes in non-alcoholic fatty liver disease in patients with impaired glucose tolerance and newly detected untreated type 2 diabetes. Indian J Endocrinol Metab. Sep-Oct 2015;19(5):597-601.

doi: 10.4103/2230-8210.163172

Mandal A, Bhattarai B, Kafle P, Khalid M, Jonnadula SK , Lamicchane J, et al. Elevated Liver Enzymes in Patients with Type 2 Diabetes Mellitus and Non-alcoholic Fatty Liver Disease. Cureus 2018 Nov 23;10(11):e3626.

doi: 10.7759/cureus.3626.

Kanwal S, Ghaffar T, Aamir AH, Usman K. Frequency of non-alcoholic fatty liver disease in patients with type-2 diabetes mellitus and its associated risk factors. Pakistan Journal of Medical Sciences. 2021 Sep;37(5):1335-41.

doi: 10.12669/pjms.37.5.4211

Shah AS, Khan S, Rahim H, Chishti KA, Khan AG. Prevalence of nonalcoholic fatty liver and non-alcoholic steatohepatitis in Peshawar Cantonment, Khyber Pakhtunkhwa, Pakistan. Pak J Pharm Sci. 2018;31(1):193–98

http://www.pips.pk/default.aspx#

Rashid A, Zafar S, Bashir A, Bakht K, Bhalli AU. Presence of non-alcoholic fatty liver disease in patients of uncontrolled and controlled type 2 diabetes mellitus. Pak Armed Forces Med J. 2019;69(4):822–25

https://www.pafmj.org/index.php/PAFMJ/article/view/3207

Taseer IH, Hussain L, Safdar S, Mirbahar AM, Ahmad I. Frequency of non-alcoholic fatty liver disease (NAFLD) and its biochemical derangements in Type-2 diabetic patients. Pak J Med Sci. 2009;25(5):817–20

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Copyright (c) 2023 Lubna Meraj