The cross-sectional study on changes in fasting lipid profile and liver enzyme in type 2 diabetic patients in tertiary healthcare
DOI:
https://doi.org/10.18203/2320-6012.ijrms20251297Keywords:
Type 2 diabetes mellitus, Liver enzymes, Glycaemic, Fasting lipid profileAbstract
Background: Type 2 Diabetes Mellitus (T2DM) is associated with metabolic dysfunctions, including Dyslipidemia and liver enzyme abnormalities. Elevated fasting lipid profiles and liver enzymes have been linked to poor glycaemic control, increasing the risk of cardiovascular disease and non-alcoholic fatty liver disease (NAFLD). This study aims to investigate the correlation between glycaemic status, lipid abnormalities, and liver enzyme alterations in T2DM patients.
Methods: A cross-sectional observational study was conducted at Dr. M.K. Shah Medical College & Research Centre and Smt. S.M.S. Multispecialty Hospital, Ahmedabad. A total of 125 T2DM patients were enrolled based on ADA guidelines. Demographic data, glycaemic parameters (FBS, PPBS, HbA1c), fasting lipid profile, and liver function tests (SGOT, SGPT) were analyzed. Data were statistically assessed using SPSS version 20, with a p value <0.05 considered significant.
Results: A significant association was observed between poor glycaemic control (HbA1c>10%) and elevated liver enzymes, with a fivefold increase in SGOT and SGPT levels (p<0.05). Dyslipidemia was highly prevalent, with increased triglycerides and LDL levels strongly correlating with worsening glycaemic status. HDL levels showed no significant association.
Conclusions: The findings emphasize the importance of monitoring liver function and lipid profiles in T2DM patients to prevent complications such as NAFLD and cardiovascular disease. Early detection of metabolic abnormalities can aid in risk stratification and targeted therapeutic interventions for better diabetes management.
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References
International Diabetes Federation. IDF Diabetes Atlas. 10th ed. Brussels: IDF; 2021.
Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. IDF Diabetes Atlas: Global and regional diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2021;183:109119. DOI: https://doi.org/10.1016/j.diabres.2021.109119
Zimmet P, Alberti KG, Magliano DJ, Bennett PH. Diabetes mellitus statistics on prevalence and mortality: Facts and fallacies. Nat Rev Endocrinol. 2016;12(10):616-22. DOI: https://doi.org/10.1038/nrendo.2016.105
Petersen KF, Shulman GI. Mechanisms of insulin resistance. Physiol Rev. 2018;98(4):219-62. DOI: https://doi.org/10.1152/physrev.00063.2017
Stefan N, Häring HU, Cusi K. Non-alcoholic fatty liver disease: causes, diagnosis, cardiometabolic consequences, and treatment strategies. Lancet Diabetes Endocrinol. 2019;7(4):313-24. DOI: https://doi.org/10.1016/S2213-8587(18)30154-2
Targher G, Byrne CD. Clinical review: Nonalcoholic fatty liver disease as a novel cardiometabolic risk factor for type 2 diabetes and its complications. J Clin Endocrinol Metab. 2013;98(2):483-95. DOI: https://doi.org/10.1210/jc.2012-3093
Kim D, Kim WR, Kim HJ, Therneau TM. Association between noninvasive fibrosis markers and mortality among adults with nonalcoholic fatty liver disease in the United States. Hepatology. 2013;57(4):1357-65.
Tilg H, Moschen AR. Evolution of inflammation in nonalcoholic fatty liver disease: The multiple parallel hits hypothesis. Hepatology. 2010;52(5):1836-46. DOI: https://doi.org/10.1002/hep.24001
Bril F, Cusi K. Nonalcoholic fatty liver disease: The new complication of type 2 diabetes mellitus. Endocrinol Metab Clin North Am. 2016;45(4):765–81.
Byrne CD, Targher G. NAFLD: A multisystem disease. J Hepatol. 2015;62(1 Suppl):S47-64. DOI: https://doi.org/10.1016/j.jhep.2014.12.012
Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology. Gastroenterology. 2012;142(7):1592-609.
Musso G, Gambino R, Cassader M. Emerging molecular targets for the treatment of nonalcoholic fatty liver disease. Annu Rev Med. 2010;61:375-92. DOI: https://doi.org/10.1146/annurev.med.60.101107.134820
Schuster DP, Gaillard T. The metabolic syndrome. Lancet Diabetes Endocrinol. 2005;365(9468):1415-28.
Lonardo A, Ballestri S, Guaraldi G, Nascimbeni F, Romagnoli D, Zona S, et al. Fatty liver is associated with an increased risk of diabetes and cardiovascular disease-evidence from three different disease models: NAFLD, HCV, and HIV. World J Gastroenterol. 2016;22(44):9674-95.
Han E, Lee Yh. Non-Alcoholic Fatty Liver Disease: The Emerging Burden in Cardiometabolic and Renal Diseases. Diabetes Metab J. 2017;41(6):430-7. DOI: https://doi.org/10.4093/dmj.2017.41.6.430
Wong RJ, Liu B, Bhuket T. Significant burden of NAFLD with advanced fibrosis in the US: A cross-sectional analysis of NHANES 2011–2014. Hepatology. 2018;67(2):620-6.
Targher G, Day CP, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N Engl J Med. 2010;363(14):1341-50.
Lu FB, Hu ED, Xu LM, Chen LU, Wu JL, Li H, et al. The relationship between obesity and the severity of nonalcoholic fatty liver disease: Systematic review and meta-analysis. J Clin Gastroenterol. 2015;49(8):811-21.
Brunt EM, Wong VW, Nobili V, Day CP, Sookoian S, Maher JJ, et al. Nonalcoholic fatty liver disease. Nat Rev Dis Primers. 2015;1:15080. DOI: https://doi.org/10.1038/nrdp.2015.80
Mantovani A, Byrne CD, Bonora E, Targher G. Nonalcoholic fatty liver disease and risk of incident type 2 diabetes: A meta-analysis. Diabetes Care. 2018;41(2):372-82. DOI: https://doi.org/10.2337/dc17-1902
Daniel WW. Biostatistics: A foundation for analysis in the health sciences. 7th ed. New York: Wiley; 1999.
American Diabetes Association. Standards of medical care in diabetes-2024. Diabetes Care. 2024;47(Suppl 1):S1-58.
Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology. Gastroenterology. 2012;142(7):1592-609. DOI: https://doi.org/10.1053/j.gastro.2012.04.001
World Health Organization. WHO STEPS surveillance manual: The WHO STEPwise approach to chronic disease risk factor surveillance. Geneva: WHO; 2005.
Henry JB. Clinical diagnosis and management by laboratory methods. 22nd ed. Philadelphia: WB Saunders; 2011.
Burtis CA, Ashwood ER, Bruns DE. Tietz textbook of clinical chemistry and molecular diagnostics. 5th ed. St. Louis: Elsevier; 2012.
Altman DG. Practical statistics for medical research. London: Chapman & Hall; 1991. DOI: https://doi.org/10.1201/9780429258589
IBM Corp. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp; 2011.
Rosner B. Fundamentals of biostatistics. 8th ed. Boston: Cengage Learning; 2015.
Kirkwood BR, Sterne JA. Essential medical statistics. 2nd ed. Oxford: Blackwell Science; 2003.
Norman GR, Streiner DL. Biostatistics: The bare essentials. 4th ed. Shelton, CT: PMPH-USA; 2015.
Kim D, Kim WR, Kim HJ, Therneau TM. Association between noninvasive fibrosis markers and mortality among adults with nonalcoholic fatty liver disease in the United States. Hepatology. 2013;57(4):1357–65. DOI: https://doi.org/10.1002/hep.26156
Bril F, Cusi K. Nonalcoholic fatty liver disease: The new complication of type 2 diabetes mellitus. Endocrinol Metab Clin North Am. 2016;45(4):765-81. DOI: https://doi.org/10.1016/j.ecl.2016.06.005
Targher G, Day CP, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N Engl J Med. 2010;363(14):1341-50. DOI: https://doi.org/10.1056/NEJMra0912063
Wilson PW, D’Agostino RB, Sullivan L, Parise H, Kannel WB. Overweight and obesity as determinants of cardiovascular risk: The Framingham experience. Arch Intern Med. 2002;162(16):1867-72. DOI: https://doi.org/10.1001/archinte.162.16.1867
Schuster DP, Gaillard T. The metabolic syndrome. Lancet Diabetes Endocrinol. 2005;365(9468):1415-28. DOI: https://doi.org/10.1016/S0140-6736(05)66378-7
Mohan V, Deepa R, Rani SS, Premalatha G. Prevalence of coronary artery disease and its relationship to lipids in a selected population in South India. J Am Coll Cardiol. 2001;38(3):682-7. DOI: https://doi.org/10.1016/S0735-1097(01)01415-2
Lonardo A, Ballestri S, Guaraldi G, et al. Fatty liver is associated with an increased risk of diabetes and cardiovascular disease-evidence from three different disease models: NAFLD, HCV, and HIV. World J Gastroenterol. 2016;22(44):9674-95. DOI: https://doi.org/10.3748/wjg.v22.i44.9674
Friedman GD, Selby JV, Quesenberry CP, Armstrong MA, Klatsky AL. The risk of pancreatitis among patients with diabetes. Diabetes Care. 1994;17(10):996-1000.