title: Clinical correlates of persistently elevated liver enzymes in type 2 diabetic outpatients.
abstract: To evaluate the prevalence and the clinical implication of persistently elevated liver enzymes in diabetic subjects, with no evidence of viral hepatitis infection or alcohol abuse.
  
  
  
  Clinical, lifestyle, anthropometric data and laboratory test values were collected in 916 type 2 diabetic subjects, examined for alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyltranspeptidase (γ-GT) levels at two different time points.
  
  
  
  Five hundred forty four patients (59.4%) showed normal (NLT group) and 182 (19.9%) persistently elevated (ELT group) liver tests in both determinations. ELT patients were prevalently men (P=0.016), younger (P<0.0001) and with a lower duration of diabetes (P=0.008). Adjusting for age and sex, ELT subjects had significantly higher BMI (P<0.001), waist circumference (P=0.010), systolic (P=0.017) and diastolic blood pressure (P<0.001), and higher levels of fasting blood glucose (P=0.023), and triglycerides (P<0.0001). Current hypoglycemic and/or hypolipidemic drugs were comparable between the two groups. At multivariate analysis, male gender (OR=3.017, P=0.012), worse metabolic control (HbA1c, OR=1.408, P=0.017), and a younger age (OR=1.054, P=0.007) predicted the presence of persistently elevated liver enzymes.
  
  
  
  Persistently elevated liver enzymes are a common finding in outpatient type 2 diabetic subjects, particularly in young men with suboptimal metabolic control and with the features of metabolic syndrome. The persistence of abnormal liver tests may be of potential utilization in clinical practice for the screening of patients at high risk of NAFLD.
authors.affiliation: Department of Clinical and Experimental Medicine, Messina University, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Giandalia
authors.affiliation: Department of Clinical and Experimental Medicine, Messina University, Italy.
authors.forename: Elisabetta Lucia
authors.initials: EL
authors.lastname: Romeo
authors.affiliation: Department of Clinical and Experimental Medicine, Messina University, Italy.
authors.forename: Maria Concetta
authors.initials: MC
authors.lastname: Ruffo
authors.affiliation: Department of Clinical and Experimental Medicine, Messina University, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Muscianisi
authors.affiliation: Department of Clinical and Experimental Medicine, Messina University, Italy.
authors.forename: Letterio
authors.initials: L
authors.lastname: Giorgianni
authors.affiliation: Department of Clinical and Experimental Medicine, Messina University, Italy.
authors.forename: Fiorella
authors.initials: F
authors.lastname: Forte
authors.affiliation: Department of Clinical and Experimental Medicine, Messina University, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Cucinotta
authors.affiliation: Department of Clinical and Experimental Medicine, Messina University, Italy. Electronic address: girusso@unime.it.
authors.forename: Giuseppina Tiziana
authors.initials: GT
authors.lastname: Russo
mesh_terms: D000367:Age Factors; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D004796:Clinical Enzyme Tests; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007558:Italy; D016014:Linear Models; D008099:Liver / Q000201:enzymology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D016017:Odds Ratio; D010045:Outpatients; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D015854:Up-Regulation; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D015415:Biomarkers; D005723:gamma-Glutamyltransferase; C554782:gamma-glutamyltransferase, human; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: Liver; NAFLD (non-alcoholic fatty liver disease); Persistently elevated liver enzymes; Type 2 diabetes