Hepatobiliary dysfunction in Type-2 diabetes mellitus

Abstract

Objective:Nonalcoholic fatty liver disease (NAFLD) and gallstones are frequently present in diabetics, but its exact prevalence is not well studied in India. We have done a prevalence study of hepatobiliary involvement in Type-2 diabetes mellitus (T2DM) and also studied the other risk factors of NAFLD.Materials and Methods:Two hundred diabetics and 200 controls underwent anthropometric measurements, abdominal ultrasonography, (USG) and biochemical tests at a tertiary care hospital. Univariate and multivariate logistic regression analyses were done.Results:One hundred and thirty (65%) diabetics and 47 (23.50%) controls were having USG evidence of fatty liver (odds ratio [OR] = 6.046, 95% confidence interval [CI]: 3.904–9.363 [P < 0.0001]). Raised liver enzymes were present in 42 (21%) diabetics and 16 (8%) controls [OR = 3.057, 95% CI: 1.654–5.648 [P < 0.004]). Gallstones were present in 32 (16%) diabetics and 10 (5%) controls (OR = 2.825; 95% CI: 1.850–4.315 P < 0.0001). In addition, waist circumference (WC) and body mass index (BMI) were significantly more in diabetics, but lipid profile was not significantly deranged as compared to controls. Then, all patients with fatty liver were compared with patients with normal liver, and we found that fatty liver group was having raised BMI, WC, liver enzymes, and more dyslipidemia. Multivariate analysis was done which shows the presence of T2DM, elevated liver enzymes, obesity, and elevated WC as independent risk factors of fatty liver.Conclusion:The prevalence of NAFLD and gallstones was higher in diabetics as compared to healthy population. In addition, the presence of T2DM, elevated liver enzymes, obesity, and elevated WC are independent predictors of NAFLD.

Prevalence and Association of Elevated Liver Transaminases in Type 2 Diabetes Mellitus Patients in Jeddah, Saudi Arabia

“…The findings from this study showed that the levels of serum AST and ALT were elevated in 6.16% and 7.58% of T2DM patients, respectively. Our studies are in accordance with several previous studies that also found serum transaminases were elevated in T2DM [7,10-11,18-19].…”

“…We found no significant difference according to BMI while another study reported a risk of increased ALT in diabetic patients with obesity [11]. Furthermore, the measurement of transaminases is more important in obese diabetic subjects according to one study that stated that the presence of T2DM, obesity, and elevated ALT, AST, WC are independent risk factors for fatty liver [18].…”

Trend of Non-Alcoholic Fatty Liver Disease in Type II Diabetes Mellitus

“…A cross-sectional study was done at Medical Unit 2 of Sir Ganga Ram Hospital in Lahore from January 29 to July 29, 2020, and ethical approval was obtained from the institution review board with reference number CPSP/REU/MED-2017-059-13448. A 200-sample size of patients was estimated with confidence level (95%), margin of error (5%), and predicted percentage of NAFLD such as ≥51% in siblings of TIIDM patients using consecutive sampling technique and non-probability methods 11 . Patients in the age range of 40-70 were chosen who met the inclusion criteria and had type II diabetes (HbA1c>6.5% and/or on treatment for diabetes or symptoms of hyperglycemia and random blood sugar level (BSL)>200mg/dL for more than 1 year).…”