Alshalani Abdulrahman, AlAhmari Nada, Amin Hajar A, Aljedai Abdullah, AlSudais Hamood
Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia.
J Clin Med. 2025 Jul 28;14(15):5324. doi: 10.3390/jcm14155324.
: The global increase in type 2 diabetes mellitus (T2DM) cases necessitates the need for early detection of metabolic changes. This study investigated variations in liver enzymes, renal markers, electrolytes, and lipid profiles among T2DM patients stratified by hemoglobin A1c (HbA1c) categories to support early identification and better management of diabetes-related complications. : A retrospective observational study at King Khalid University Hospital (KKUH), Riyadh, included 621 adult patients diagnosed with T2DM categorized into four HbA1c groups: normal (<5.7%), prediabetes (5.7-6.4%), controlled diabetes (6.5-7.9%), and uncontrolled diabetes (≥8.0%). Biochemical parameters included the liver profile: alkaline phosphatase (ALP) and bilirubin, renal profile: creatinine, blood urea nitrogen (BUN), glucose, sodium, and chloride, and lipid profile: cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides. Regression models identified predictors of ALP, cholesterol, and LDL. : ALP was higher in uncontrolled diabetes (89.0 U/L, Q1-Q3: 106.3-72.0) than in the prediabetes group (75.0 U/L, Q1-Q3: 96.8-62.3). Sodium and chloride were lower in uncontrolled diabetes (Na: 138.3 mmol/L, Q1-Q3: 140.3-136.4; Cl: 101.1 mmol/L, Q1-Q3: 102.9-99.4) compared to the normal group (Na: 139.5 mmol/L, Q1-Q3: 142.4-136.9; Cl: 103.5 mmol/L, Q1-Q3: 106.1-101.7). LDL was lower in uncontrolled diabetes (2.1 mmol/L, Q1-Q3: 2.8-1.7) than in the normal group (2.8 mmol/L, Q1-Q3: 3.7-2.2), while triglycerides were higher in patients with uncontrolled diabetes compared to the normal group (1.45 mmol/L, Q1-Q3: 2.02-1.11 vs. 1.26 mmol/L, Q1-Q3: 1.44-0.94). Regression models showed low explanatory power (R = 2.1-7.3%), with weight, age, and sex as significant predictors of select biochemical markers. : The study observed biochemical variations across HbA1c categories in T2DM patients, likely reflecting insulin resistance. Monitoring these markers in conjunction with HbA1c can enhance early detection and improve the management of complications.
全球2型糖尿病（T2DM）病例的增加使得早期发现代谢变化成为必要。本研究调查了按糖化血红蛋白A1c（HbA1c）类别分层的T2DM患者的肝酶、肾标志物、电解质和血脂谱的变化，以支持糖尿病相关并发症的早期识别和更好管理。：利雅得国王哈立德大学医院（KKUH）的一项回顾性观察研究纳入了621名被诊断为T2DM的成年患者，分为四个HbA1c组：正常（<5.7%）、糖尿病前期（5.7 - 6.4%）、血糖控制良好的糖尿病（6.5 - 7.9%）和血糖控制不佳的糖尿病（≥8.0%）。生化参数包括肝功能：碱性磷酸酶（ALP）和胆红素；肾功能：肌酐、血尿素氮（BUN）、葡萄糖、钠和氯；血脂谱：胆固醇、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）和甘油三酯。回归模型确定了ALP、胆固醇和LDL的预测因素。：血糖控制不佳的糖尿病患者的ALP（89.0 U/L，四分位间距：106.3 - 72.0）高于糖尿病前期组（75.0 U/L，四分位间距：96.8 - 62.3）。血糖控制不佳的糖尿病患者的钠和氯（钠：138.3 mmol/L，四分位间距：140.3 - 136.4；氯：101.1 mmol/L，四分位间距：102.9 - 99.4）低于正常组（钠：139.5 mmol/L，四分位间距：142.4 - 136.9；氯：103.5 mmol/L，四分位间距：106.1 - 101.7）。血糖控制不佳的糖尿病患者的LDL（2.1 mmol/L，四分位间距：2.8 - 1.7）低于正常组（2.8 mmol/L，四分位间距：3.7 - 2.2），而血糖控制不佳的糖尿病患者的甘油三酯高于正常组（1.45 mmol/L，四分位间距：2.02 - 1.11 vs. 1.26 mmol/L，四分位间距：1.44 - 0.94）。回归模型显示解释力较低（R = 2.1 - 7.3%），体重、年龄和性别是选定生化标志物的重要预测因素。：该研究观察到T2DM患者不同HbA1c类别间的生化变化，这可能反映了胰岛素抵抗。结合HbA1c监测这些标志物可加强早期检测并改善并发症的管理。
