2019, Vol. 1, Issue 2, Part A

Diabetes mellitus is a chronic condition that occurs when the body cannot produce enough or effectively use of insulin. Compared with individuals without diabetes, patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality, and are disproportionately affected by cardiovascular disease. Most of this excess risk is it associated with an augmented prevalence of well-known risk factors such as hypertension, dyslipidaemia and obesity in these patients. However the improved cardiovascular disease in type 2 diabetes mellitus patients can not be attributed solely to the higher prevalence of traditional risk factors. Therefore other non-traditional risk factors may be important in people with type 2 diabetes mellitus. Cardiovascular disease is increased in type 2 diabetes mellitus subjects due to a complex combination of various traditional and non-traditional risk factors that have an important role to play in the beginning and the evolution of atherosclerosis over its long natural history from endothelial function to clinical events. Statistical analysis was performed using student t test at level of significance 0.0001 and Pearson’s correlation coefficient at level of significance of 0.05. The study subjects were chosen after performing liver function tests. Ultrasonography was performed to diagnose hepatic changes such as fatty infiltration, Non-alcoholic fatty liver disease (NAFLD) and Non-alcoholic steatohepatitis (NASH); secondary to Diabetes mellitus. Those found to have NAFLD and elevated levels of enzymes were further evaluated for presence of microalbuminuria. Among the liver enzymes, SGOT, SGPT and ALP showed highly significant positive correlation with duration of the disease, HbA1c levels, altered liver echotexture, age and BMI of the patients at p< 0.05. 31 (31%) among these study subjects were found to have microalbuminuria. Thus presence of renal dysfunction among diabetic subjects with liver dysfunction was found to be highly significant at p< 0.0001.

In conclusion, our study found that pathophysiology of T2DM indeed contributes to an elevation in liver enzymes, especially SGOT, SGPT and ALP and results in an alteration of hepatic echotexture as evidenced on Ultrasonography. Microalbuminuria is a commonly used for screening for nephropathy. In addition, evaluation of liver enzymes by biochemical tests and performing ultrasonography in T2DM patients at regular intervals may assist in preventing undue progression and worsening of disease by enabling earlier initiation of appropriate management.