Endocrine Abstracts

Objective: Patients with diabetes mellitus often have abnormal liver function tests without any symptoms. Our aim in this study was to evaluate the frequency and cause of abnormal LFTS in diabetic patients.

Methods: 150 patients were enrolled from diabetic clinic who had been diagnosed with diabetes (creatinine,fasting glucose,random glucose, GTT were recorded). The following demographic data were recorded from each patients: age,sex, duration of diabetes, BMI, waist circumference, lipid profile, HbA1c, BP (blood pressure). All patients had liver function tests performed and of these patients with abnormal LFTS, underwent full hepatitis screening including ultrasound of hepatobiliary system. If the cause for the abnormal LFTS, was still elusive the patients underwent a liver biopsy and was seen by hepatologist.

Results: 54% of patients had abnormal LFTS,of which 61% had hepatitic picture and 28% a mixed hepatitic and cholestatic picture. The remainder 11% had cholestatic picture. The majority of patients with abnormal LFTS had non-alcoholic fatty liver disease (NAFLD) 94%, and 4% had non -alcoholic steatohepatitis (NASH). 0.7% had autoimmune liver disease, 0.2% had viral hepatitis,and 0.1% haemachromatosis and 1% cholelithiasis. In the cohort of patients with NAFLD or NASH there was poor glycaemic control, obesity,abnormal LFTS and hypertension.

Conclusion: Abnormal LFTS in diabetic patients dictate further investigations with treatment of underlying cause.Patients with NAFLD or NASH often have more than one components of the metabolic syndrome and the later patients are usually poorly controlled.