Assessment of liver enzymes as diagnostic biomarkers in type 2 diabetes mellitus: a cross-sectional study in Zakho, Iraq

ABSTRACT

Background

This study aimed to identify the prevalence and factors associated with abnormal liver enzyme profiles in individuals with type 2 diabetes (T2D) in Zakho, to assess the association between demographic characteristics, clinical parameters, kidney function tests, lipid profiles, glucose levels, and T2D, and to identify resident risk factors.

Research design and methods

A cross-sectional analysis of T2D patients admitted to Zakho General Hospital was conducted utilizing hospital records. The primary endpoint of interest was attaining HbA1C levels ≥ 6.5%. Analytical methodologies encompassed linear and multivariate logistic regression analyses, with due consideration of the association between diverse parameters and glycemic alterations. Further, the predictive value of biomarkers was evaluated through Receiver Operating Characteristic (ROC) curves and Area Under the Curve (AUC) analyses, complemented by Spearman correlation analysis to explore relationships among laboratory parameters.

Results

The study found that 89.4% of participants had HbA1C levels above 6.5%, with a preference for T2D among older individuals (mean age: 52.93–49.89 respectively) and females. Age, glucose levels, and liver enzymes positively correlated with HbA1C.

Conclusions

The study emphasizes the diagnostic importance of liver enzymes in individuals with type 2 diabetes, suggesting that these biomarkers could be valuable indicators of disease severity and progression.

KEYWORDS:

• Type 2 diabetes mellitus
• hyperglycemia risk factors
• glycated hemoglobin A1c
• liver enzymes
• diagnostic biomarkers

Acknowledgments

The authors thank the staff of the Zakho General Hospital for their continuous help during sample data collection.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethics statement

This study utilized de-identified patient data retrieved from hospital records. As the data used in this research did not involve any direct contact with patients, the study was exempt from ethics approval in accordance with the Research Ethics Committee of the Duhok Directorate General of Health in Duhok, Iraq, guidelines and ethical regulations.

Author contribution statement

Dilveen Y. Ahmed: Contributed significantly to study conception, data collection, and initial draft writing. Lina N. Adam: Conceptualized the study, supervised research activities, curated data, conducted statistical analysis, managed project administration, wrote the original draft, and provided extensive editing. Resan A. Ahmed: Assisted in data collection and contributed to drafting the manuscript. Mohammed K. Mirza: Participated in data collection and contributed to the drafting of the manuscript. All authors have actively participated in drafting, revising, and critically reviewing the article. They unanimously agreed on the submission journal, reviewed and approved all article versions throughout the submission, revision, and final acceptance stages, including significant changes made during proofing. The authors collectively take responsibility for the article’s content and are committed to addressing any inquiries concerning its accuracy and integrity after publication.

Additional information

Funding

This paper was not funded.