1Department of Biotechnology, Lahore College for Women University, Lahore, Punjab, Pakistan.
2Department of Zoology, Lahore College for Women University, Lahore, Punjab, Pakistan.
Endocr Regul. 2023 Sep 16;57(1):200-220. doi: 10.2478/enr-2023-0024. Print 2023 Jan 1.
Diabetes mellitus is characterized by hyperglycemia and abnormalities in insulin secretion and function. This review article focuses on various liver parameters, including albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), alpha fetoprotein (AFP), alpha 1 antitrypsin (AAT), ammonia, bilirubin, bile acid, gamma-glutamyl transferase (GGT), immunoglobulin, lactate dehydrogenase (LDH), and total protein. These parameters play significant roles in the development of different types of diabetes such as type 1 diabetes (T1DM), type 2 diabetes (T2DM) and gestational diabetes (GDM). The article highlights that low albumin levels may indicate inflammation, while increased ALT and AST levels are associated with liver inflammation or injury, particularly in non-alcoholic fatty liver disease (NAFLD). Elevated ALP levels can be influenced by liver inflammation, biliary dysfunction, or bone metabolism changes. High bilirubin levels are independently linked to albuminuria in T1DM and an increased risk of T2DM. Elevated GGT levels are proposed as markers of oxidative stress and liver dysfunction in T2DM. In GDM, decreased serum AFP levels may indicate impaired embryo growth. Decreased AFP levels in T2DM can hinder the detection of hepatocellular carcinoma. Hyperammonemia can cause encephalopathy in diabetic ketoacidosis, and children with T1DM and attention deficit hyperactivity disorder often exhibit higher ammonia levels. T2DM disrupts the regulation of nitrogen-related metabolites, leading to increased blood ammonia levels. Bile acids affect glucose regulation by activating receptors on cell surfaces and nuclei, and changes in bile acid metabolism are observed in T2DM. Increased LDH activity reflects metabolic disturbances in glucose utilization and lactate production, contributing to diabetic complications. Poor glycemic management may be associated with elevated levels of IgA and IgG serum antibodies, and increased immunoglobulin levels are also associated with T2DM.
糖尿病的特征是高血糖和胰岛素分泌及功能异常。本文重点关注各种肝脏参数，包括白蛋白、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、碱性磷酸酶（ALP）、甲胎蛋白（AFP）、α1 抗胰蛋白酶（AAT）、氨、胆红素、胆汁酸、γ-谷氨酰转移酶（GGT）、免疫球蛋白、乳酸脱氢酶（LDH）和总蛋白。这些参数在不同类型的糖尿病（如 1 型糖尿病（T1DM）、2 型糖尿病（T2DM）和妊娠期糖尿病（GDM））的发展中起着重要作用。文章强调，白蛋白水平低可能表明存在炎症，而 ALT 和 AST 水平升高与肝脏炎症或损伤有关，特别是在非酒精性脂肪性肝病（NAFLD）中。ALP 水平升高可能受到肝脏炎症、胆汁功能障碍或骨代谢变化的影响。胆红素水平升高与 T1DM 的白蛋白尿和 T2DM 的风险增加独立相关。GGT 水平升高被认为是 T2DM 中氧化应激和肝功能障碍的标志物。在 GDM 中，血清 AFP 水平降低可能表明胚胎生长受损。T2DM 中 AFP 水平降低会阻碍肝细胞癌的检测。高氨血症可导致糖尿病酮症酸中毒性脑病，患有 1 型糖尿病和注意缺陷多动障碍的儿童常表现出较高的氨水平。T2DM 会破坏与氮相关代谢物的调节，导致血氨水平升高。胆汁酸通过激活细胞表面和核受体来影响葡萄糖调节，并且在 T2DM 中观察到胆汁酸代谢的变化。LDH 活性的增加反映了葡萄糖利用和乳酸生成的代谢紊乱，导致糖尿病并发症的发生。血糖控制不佳可能与血清 IgA 和 IgG 抗体水平升高有关，而免疫球蛋白水平升高也与 T2DM 有关。
