Hepatic Involvement with Elevated Liver Enzymes in Nepalese Subjects with Type 2 Diabetes Mellitus

Background: Diabetes mellitus (DM) is characterized by a broad disturbance in metabolism. Since the liver plays a vital role in the regulation of metabolism, there is evidence of liver dysfunction in DM. There is a high prevalence of non-alcoholic fatty liver disease among diabetic patients in western countries. However, there is a paucity of data showing of such association in Nepalese patients with DM. Therefore, the present study was carried out for a better understanding of alteration of liver function in patients with type 2 DM (T2DM).

Methods: A total of 105 patients (age between 30-74 years, male/female ratio=0.6), newly diagnosed as T2DM, without the history of liver disease and other chronic diseases, were recruited from out-patient department of Nepal Medical College Teaching Hospital along with 58 age and sex matched healthy controls (age between 30-71 years, male/female ratio=0.7). After basic anthropometric measurements, fasting venous blood was collected and subjected to analysis for liver enzymes.

Results: We observed marginal, yet statistically significant increase of serum alanine transferase (26.6±0.84 (diabetic) vs 20.0±0.69 (control), p=0.003) and γ-glutamyl transferase (40.4±1.51(diabetic) vs 21.2±1.1(control), p<0.001) in the diabetic patients compared to healthy controls.

Conclusion: The liver enzymes were marginally elevated in T2DM compared to controls. This increment may be associated with early pathological changes in the liver. Hence, regular monitoring of liver function is highly beneficial to prevent advance liver injury in T2DM.