Belay Zawdie Wondimu
Jimma University, Ethiopia
Background: The liver is an insulin-sensitive organ. Insulin resistance is recognized as a pathological factor in the development of liver function impairment and in non alcoholic fatty liver disease (NAFLD). Studies on liver function abnormalities in type 2 diabetic patients in Ethiopia are lacking. Aim: Aim of this study is to assess liver function tests in patients with type 2 diabetes mellitus and examine factors associated with these biochemical changes. Methods: A cross-sectional study was conducted on type 2 diabetic patients attending at diabetic center, TASTH. By assessing their file and using the well-designed questioners, the type 2 diabetic patients with history of alcohol intake, hepatotoxic drugs like amiodarone, antituberculous drugs and herbs like khat, shisha, clinical evidence chronic hepatitis (of the 80 patients with type 2 DB, one in five (16) patients were tested for chronic hepatitis B (HBV) and chronic hepatitis C (HCV), using serum anti�??HCV antibody and hepatitis B surface antigen (HBs Ag). All 16 patients who showed no evidence for chronic HBV or HCV infection were excluded from this study. However, none of the 64 diabetic patients and 60 non-diabetic patients was tested for chronic HCV and HBV due to financial constraints. Patients with severe or devastating diseases such as cancers and severe anemia (hemoglobin<10 g/dL); patients with HIV and on using HAART and pregnant women were excluded from this study. Out of 100 randomly selected diabetic patients, 80 individuals fulfilled the criteria set up for inclusion, while 20 were excluded. 5 mL of venous blood were drawn from each volunteer type 2 diabetic patients in this study using a 5 mL disposable plastic syringe by the professional nurse. The blood was poured in a plane container and then centrifuged after clotted. Serum was kept at 20°C in sterile condition till used. Liver enzymes (AST, ALT, and ALP), lipid profiles (TC, HDL, TAG) and serum glucose were measured and analyzed by using automated machine Roche Diagnostic/Hitachi 902, Germany according to the manufacturer procedures (protocols). But concentrations of TP, TB and DB were determined manually. The data collected using structural format and appropriate equipment and reagents were entered in to SPSS for window version 20. Independent sample t test and curve estimation regression analysis were carried out to compare the LFTs and lipid profiles in the patients with the non-diabetic 60 control individuals. Results: Mean values of liver function tests (ALT, AST, ALP, TP, Bilirubin) and lipid profiles (TC, LDL, HDL, TAG ) were significantly higher in diabetic patients compared with the non-diabetic controls (P<0.05). In contrast, total protein and high density lipoprotein concentrations in diabetic patients were lower compared with non-diabetic control group (P<0.01). Overall, 22 patients (25%) had at least one or more abnormal liver function tests and lipid profiles. 39 patients (48.75%), 62 patients (77.5%), 47 patients (58.75%), 52(65%) patients had abnormal total serum cholesterol, LDL, TAG and HDL levels respectively. The liver function and lipid profile tests among different anti diabetic on taking groups of the study patients were not statically significant at p value <0.05. Conclusion: Elevated parameters were greater among persons with type 2 diabetic patients. There was less association between liver function impairments with the anti-diabetic drugs.
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