Prevalence of elevated hepatic transaminases among Jordanian patients with type 2 diabetes mellitus

ABSTRACT

Since the extent of elevation of liver transaminases in type 2 diabetics in Jordan and most of the Middle East is unknown, we estimated the prevalence of elevated liver transaminase levels among patients with type 2 diabetes and determined associated risk factors. This study was performed on 1014 consecutive type 2 diabetic outpatients who attended the National Center for Diabetes, Endocrinology and Genetics in Amman, Jordan. The patients' age ranged between 26-85 years with a mean age of 56.8 [+9.8]. Three- hundred and fifty three [54.5%] were males with a median age of 58 years [ranging between 26-82 years], and four hundred and sixty one [45.5%] were females with a median age of 57 years [ranging between 28-85 years]. Body mass index, waist circumference, lipid profile, and hepatic transaminase levels were recorded. Ultraonography was performed in those with elevated alanine transaminase levels. Overall, the prevalence of elevated alanine transaminase [ALT] level was 10.4% [n=105] with the gender-wise prevalence being 12.8% [n=71] in men and 7.4% [n=34] in women. The prevalence of elevated aspartate transaminase [AST] levels was 5.4% [n=56] with the gender-wise prevalence being 5.6% [n=31] in men and 5.4% [n=25] in women. Only 4.5% [n=44] showed elevated levels of both ALT and AST. Male gender [OR=2.35, Cl 1.5-3.8] and high waist circumference [OR=1.9, Cl 1.2-3.2] were associated with increased risk of elevated ALT levels. Younger patients had a higher tendency to have elevated ALT compared to those over 65 years [OR=12.4 for patients aged 25-45years, and OR=5.8 for those who were 45-65 years old]. Non-insulin use was associated with a high odds ratio for elevated ALT levels [OR=1.7, Cl 1.1 -2.9]. Elevated ALT and AST levels are found in 10.4% and 5.4% of our type 2 diabetic patients respectively. Male gender, younger age, higher waist circumference; as an indicator of central obesity, as well as non insulin use are independent predictors of elevated liver transaminase levels