Liver enzymes and glycemic control markers in uncontrolled type 2 diabetes mellitus- A case control study

Introduction: Mild increase in liver enzymes, may be a marker for significant liver injury. The increased transaminases and hepatomegaly are found to be reversible with glycemic control. Objectives: 1. To compare the liver enzyme levels between type 2 DM with healthy controls 2. To study the correlation between FBS, HbA1c and Liver enzymes 3.To find the best cut-off values of AST and ALT, to suspect the non-alcoholic fatty liver disease (NAFLD) in DM. Materials and Method: The study was conducted at HSK hospital, Bagalkot. Fifty subjects participated in Uncontrolled type 2 DM (HbA1c >7) group and Controls.Biochemical parameters like FBS, urea, creatinine, liver function tests and HbA1c were estimated. All the subjects underwent ultrasonography of abdomen to detect the fatty liver. Results: The biochemical parameters FBS, HbA1c, blood urea, serum bilirubin, liver enzymes namely AST, ALT and GGT were raised significantly in T2DM patients compared to controls. There was positive correlation between FBS and HbA1c and the liver enzymes AST, ALT and GGT(P=0.0001). Best cut-off value of liver enzymes was calculated using ROC curve and the values for AST, ALT and GGT were >34 IU/L, 28 IU/L and 24.3 IU/L respectively. Conclusion: Increased liver enzymes in uncontrolled type 2 DM, positively correlated with glycemic markers, when AST >34 u/l and ALT >28U/L, can act as a predictor NAFLD and may be useful for further evaluation of patients.