Frequency of Elevated Serum Alanine Transaminase in Patients With Type 2 Diabetes Mellitus
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Background: Type 2 diabetes mellitus is a common metabolic disorder associated with systemic complications, including possible hepatic biochemical abnormalities. Serum alanine transaminase is a widely available marker of hepatocellular injury and may help identify diabetic patients who require further hepatic assessment, although ALT elevation alone does not confirm non-alcoholic fatty liver disease. Objective: To determine the frequency of elevated serum alanine transaminase among patients with type 2 diabetes mellitus presenting to a tertiary care hospital in Abbottabad, Pakistan, and to assess its association with gender and duration of diabetes. Methods: This hospital-based cross-sectional study was conducted at Medical Unit A, Ayub Teaching Hospital, Abbottabad, from January 2024 to June 2024. A total of 245 patients with type 2 diabetes mellitus were enrolled through non-probability convenience sampling. Patients aged more than 20 years were included, while those with alcohol intake, hepatotoxic drug use, chronic liver disease, viral hepatitis, or hepatic malignancy were excluded. Serum ALT ≥40 IU/L was considered elevated. Data were analyzed using SPSS version 22, and associations were assessed using the chi-square test. Results: The mean age was 54.3 ± 10.8 years, and the mean serum ALT level was 36.7 ± 14.5 IU/L. Elevated ALT was observed in 56 patients, giving a frequency of 22.9%. Elevated ALT was significantly more common in males than females (29.0% vs 15.0%; OR 2.32, 95% CI 1.22–4.43; p=0.011) and increased with longer diabetes duration, reaching 34.5% among patients with diabetes for more than 10 years (OR 3.03, 95% CI 1.34–6.86; p=0.004). Conclusion: Elevated serum ALT was common among patients with type 2 diabetes mellitus and was significantly associated with male gender and longer diabetes duration. Routine liver enzyme monitoring may help identify diabetic patients requiring further hepatic and metabolic evaluation.
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