Liver disease in patients with diabetes mellitus

Abstract

SummaryLiver function tests were assessed in 60 unselected out-patient diabetics stabilized on insulin or oral hypoglycaemic agents. Routine liver function tests, particularly plasma concentrations of y-glutamyl transpeptidase and alkaline phosphatase were elevated occasionally but rarely to more than twice the upper limit of normal. There was no correlation between measures of diabetic control and results of liver function tests. Twelve (20 %) patients had evidence of gall stones, a prevalence above the expected from the community. Fourteen (23%) patients had an abnormally bright liver ultrasound echo pattern, probably indicative of fatty infiltration of the liver. This echo pattern was associated with only a minimal rise in plasma alanine amino transferase and alkaline phosphatase concentrations. It is concluded that functionally significant liver disease is uncommon amongst stabilized diabetic patients.

Elevated liver enzyme activity in construction workers: prevalence and impact on early retirement and all-cause mortality

“…The association observed between liver enzyme elevations and diabetes corresponds to other reports of higher GGT activity among diabetics [9,14,26,31]. Microsomal induction of GGT, probably due to carbohydrates, with subsequent hyperglycemia and hypertriglyceridemia has been hypothesized [18].…”

Statins and hepatotoxicity: Focus on patients with fatty liver

“…Although there are no supporting direct data, due to their effects on hepatic cholesterol and apolipoprotein synthesis, Caldwell et al raised the theoretical possibility of statins given for long term may worsen hepatic histology in patients with NAFLD. 23 This issue is important not only because NAFLD is common in patients with hyperlipidemia and type 2 diabetes (primary targets for long term statins) [24][25][26][27] but the presence of fatty liver disease may itself portray higher cardiovascular risk necessitating statin therapy. [28][29][30] The studies examining the safety of statins in patients with NAFLD are limited, but the existing data provide some evidence that they can be used safely in patients with proven or suspected NAFLD who require statins for primary or secondary prevention of cardiovascular disease.…”

Pomegranate flower ameliorates fatty liver in an animal model of type 2 diabetes and obesity

“…It is characterized by a wide spectrum of liver damage: simple steatosis may progress to advanced fibrosis and to cryptogenic cirrhosis through steatohepatitis, and ultimately to hepatocellular carcinoma (Festi et al, 2004). Although NAFLD is a syndrome with a multifactorial aetiology (Chitturi and Farrell, 2001), obesity, type 2 diabetes and hyperlipidemia are the most common associated factors (Foster et al, 1980;Stone and Van Thiel, 1985;Silverman et al, 1989;James and Day, 1999;Festi et al, 2004) both in children and in adults.…”