Clinical and Biochemical Characteristics and Aetiology of Asymptomatic Raised Alanine Aminotransferase in Newly Detected Diabetes and Impaired Glucose Tolerance Patients

Abstract

Objectives: Clinical evaluation and identification of aetiology of asymptomatic raised serum alanine aminotransferase (ALT) level in newly detected adult diabetic and impaired glucose tolerance (IGT) patients.Methods: In this cross-sectional study, newly detected adult diabetic and IGT patients having asymptomatic raised serum ALT level of > 1.5 times of upper limit of normal were evaluated clinically and by laboratory tests.Results: Total number of patients was 120, which was 3.1% of all newly registered diabetic and IGT patients over the study period. Male were 74 and female 46. Diabetes mellitus (DM) was found in 93.3% cases and IGT in 6.7%. Mean age was 43.1 years, mean body weight was 64.5 kg and mean body mass index (BMI) was 25.5 kg/m 2 . Central (abdominal) obesity was found in 61.5% cases. Increased waist hip ratio was found in 86.3% cases. Hypertension and hepatomegaly were present in 35% and 5.8% cases respectively. Dyslipidaemia was found in 98.3% cases and 45% patients fulfilled criteria for metabolic syndrome. Regarding etiology, 76.7% cases had non-alcoholic fatty liver disease (NAFLD), 8.3% had HBsAg sero-positivity, 4.2% had anti-HCV seropositivity and 3.3% had both NAFLD and HBsAg seropositivity. In 7.5% cases no cause was found. Raised serum ALT level had a significant correlation with metabolic syndrome (p= 0.016) and increasing age (p= 0.008). Conclusion

Seroepidemiology of Incidentally Detected Asymptomatic HBsAg Positive Subjects from Southern State of India – A One Year Study

“…Serum alanine transaminase which is known as a marker of liver damage was seen to be raised in 12% of the subjects which is similar to the reports of Rahman MM. as 12.33% [24]. This is less when compared to reports by other authors Reza M. as 17 the 'e' antigen negative group because these individuals were in unrecognized disease phase or that the 'e' antigen titer had simply fallen below the threshold levels but not below the threshold functional impact [20].…”

“…Nearly 8% of the tested IDAHS were positive for HBeAg, which similar to the results reported by Puri AS. as 5-37%,Ijoma U as 8.6%, MM Rahman as 9.3% [18,23,24] but less when compared to the reports by Reza. M. 11.7%, K S Rashmi as 12.89%, Malik K. as 15%, Shiha G 18%, V.Dixit as 21%, Kokhar N. as 21%, Rahman M. A as 23% Chan HL as 31% and Chandra et al as 45% [11][12][21][22][25][26][27][28].…”

“…Dixit as 79%, Malik K. as 79%, Shiha G. as 81.6%, Rashmi K. S. as 81% [11,12, 21,22,24,], but less when compared to reports by Rahman MM. as 86% and Reza M. as 88% [24,25]. Some authors have reported it to be positive in less percentage of individuals like Chandra et al as 53%, Chan HL as 69% and.…”

Aetiology of Asymptomatic Raised Serum Alanine Aminotransferase in Patients with Type 2 Diabetes Mellitus

“…In one study from Bangladesh, Mahbub MM et al found that the commonest etiology of raised serum ALT among newly detected DM and IGT patients was NAFLD followed by hepatitis B and C virus infection. 23 Limitations of the study Short study period and small sample size were limitations of current study. Fibroscan and liver biopsy could not be done.…”