Dr Foysal Ahamed, Assistant Professor, Department of Medicine, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
Mymensingh Med J. 2021 Apr;30(2):343-350.
Type 2 Diabetes mellitus (DM) is associated with various types of liver disorders including elevated liver enzymes. This study was carried out to observe hepatocellular injury in type 2 Diabetes mellitus as evidenced by raised Alanine aminotransferase (ALT) among the type 2 Diabetes mellitus patients and to find out association between elevated ALT and glycaemic control. This was a descriptive cross-sectional comparative study carried out in Department of Medicine, Rajshahi Medical College Hospital and Rajshahi Diabetic Association Hospital, Rajshahi, Bangladesh from July 2009 to June 2010. One hundred (100) diagnosed type 2 diabetic patients according to WHO criteria and 30 apparently healthy people of both sexes were included. Age of the study people were >40 years. All of those study population were free from taking any hepatotoxic drugs, inj. Insulin, alcohol and preexisting liver disease. Detailed History, thorough clinical examination and relevant investigations were done for exclusion. The frequency of abnormal ALT, Serum bilirubin, Aspartate aminotransferase (AST), Alkaline phosphatase, Prothrombin time and Serum albumin were 30%, 6%, 7%, 6%, 54% and 12% respectively in type 2 diabetic patients and 3.3%, 00%, 00%, 6.7%, 10% and 3.3% respectively in normal people. Serum ALT (U/L) level (mean±SD) of the type 2 diabetic patients and normal people were (39.00±24.21) and (28.26±6.67) respectively. This difference is highly significant (p<0.001). Elevated serum ALT level of type 2 diabetic patients showed positive association with increased Body mass index (BMI) (p<0.05) and poor glycaemic control (p<0.05) and fatty liver (p=0.055). So, a high proportion of patients with type 2 diabetes mellitus have raised serum Alanine aminotransferase level. Elevated serum ALT level was also associated with high BMI, poor glycaemic control and fatty liver which may be a marker of NAFLD and insulin resistance.
2 型糖尿病（DM）与各种类型的肝脏疾病有关，包括肝酶升高。本研究旨在观察 2 型糖尿病患者中丙氨酸氨基转移酶（ALT）升高所证明的肝细胞损伤，并发现 ALT 升高与血糖控制之间的关系。这是一项在孟加拉国拉杰沙希医科大学医院和拉杰沙希糖尿病协会医院内科进行的描述性横断面对照研究，时间为 2009 年 7 月至 2010 年 6 月。根据世界卫生组织标准诊断的 100 名 2 型糖尿病患者和 30 名男女两性的健康人被纳入研究。研究人群的年龄均>40 岁。所有研究人群均未服用任何肝毒性药物、胰岛素、酒精和既往存在的肝脏疾病。详细的病史、彻底的临床检查和相关的调查都进行了排除。2 型糖尿病患者中异常 ALT、血清胆红素、天门冬氨酸氨基转移酶（AST）、碱性磷酸酶、凝血酶原时间和血清白蛋白的频率分别为 30%、6%、7%、6%、54%和 12%，而正常人分别为 3.3%、0%、0%、6.7%、10%和 3.3%。2 型糖尿病患者和正常人的血清 ALT（U/L）水平（均值±SD）分别为（39.00±24.21）和（28.26±6.67）。这种差异具有高度显著性（p<0.001）。2 型糖尿病患者血清 ALT 水平升高与体重指数（BMI）增加（p<0.05）、血糖控制不佳（p<0.05）和脂肪肝（p=0.055）呈正相关。因此，相当一部分 2 型糖尿病患者的血清丙氨酸氨基转移酶水平升高。血清 ALT 水平升高也与高 BMI、血糖控制不佳和脂肪肝相关，这可能是 NAFLD 和胰岛素抵抗的标志物。
