High prevalence of abnormal liver enzymes in South African patients with type 2 diabetes mellitus attending a diabetes clinic

Abstract

Objective: To determine the prevalence of liver function test abnormalities in South African black and Indian adult patients with type 2 diabetes mellitus attending a tertiary diabetes clinic.

Method: The study was a retrospective chart review of patients with type 2 diabetes attending a diabetes clinic. Recorded data included the past medical and drug history, history of alcohol abuse, anthropometry, lipid profile and liver function tests.

Results: The charts of 313 patients were reviewed. Liver function test abnormalities were found in 146 patients (46.6%). Of these, 15 patients had a history of alcohol abuse, or a past medical history that might explain the abnormality, and these patients were excluded from further analysis. Elevations in serum gamma-glutamyl transferase, alkaline phosphatase and alanine transaminase were found in 25.2% (n = 79), 23.3% (n = 73) and 15.3% (n = 48), respectively. Serum total cholesterol, triglycerides and low-density lipoprotein cholesterol were higher in the group with liver function test abnormalities when compared with subjects with normal results. Mean body mass index was similar in the two groups (32.5 vs. 33.2 kg/m2). Although morbidly obese patients (n = 42) demonstrated the highest frequency of liver enzyme derangements (54.8%), this was not statistically significant.

Conclusion: There is a high prevalence of liver function test abnormalities in this group of patients with type 2 diabetes, and this is particularly so in the morbidly obese subjects. This is comparable with the reported prevalence in the Western world. Lipid abnormalities were more frequent in the group with liver enzyme derangements.

Keywords:

• South African
• type 2 diabetes
• abnormal liver enzymes
• prevalence