Prevalence of abnormal serum liver enzymes in patients with type 2 diabetes mellitus: a cross-sectional study from China

Objectives: This cross-sectional study aimed to determine the prevalence of elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in Chinese type 2 diabetic patients and identify contributing risk factors.Methods: This cross-sectional study was conducted in rural areas of China, and 1,198 type 2 diabetic patients with complete data were recruited. Elevated ALT and AST levels were defined as >40 U/L. Prevalence of abnormal liver enzymes was analyzed and multivariable analysis was used to identify independent risk factors.Results: 10.3% and 6.1% diabetic patients had elevated ALT and elevated AST, respectively. The prevalence of elevated liver enzymes was gender-related; it was 13.8% in men and 7.5% in women for elevated ALT, and 7.4% in men and 3.1% in women for elevated AST. High triglyceride was positively associated with both elevated ALT (OR 1.80, 95% CI 1.08-3.01, p=0.024) and elevated AST (OR 2.24, 95%CI 1.08-4.65, p=0.031), while taking anti-diabetes medicine was inversely related to both elevated ALT (OR 0.48, 95% CI 0.29-0.80, p=0.005) and elevated AST (OR 0.37, 95% CI 0.17-0.82, p=0.014). The risk of elevated ALT in diabetic patients increased with the presence of obesity (OR 2.54, 95% CI 1.07-6.01, p=0.034), and was lower in women (OR 0.37, 95% CI 0.19-0.72, p=0.003). Hypertension (OR 4.33, 95% CI 1.41-13.30, p=0.011), current drinking status (OR 2.90, 95% CI 1.21-6.96, p=0.017) and national minority (OR 3.26, 95%CI 1.31-8.12, p=0.011) were risk factors for elevated AST.Conclusion: A relatively high prevalence of abnormal serum liver enzymes in diabetic patients was demonstrated in China, especially in males. More attention should be paid to preventing liver injuries in diabetic patients.