• Shuang Chen, Xiaofan Guo, Yintao Chen, Siyuan Dong, and Yingxian Sun.
• a Department of Cardiology , The First Affiliated Hospital of China Medical University , Shenyang , P.R. China.
• Postgrad Med. 2016 Nov 1; 128 (8): 770-776.

ObjectivesThis cross-sectional study aimed to determine the prevalence of elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in Chinese type 2 diabetic patients and identify contributing risk factors.MethodsThis cross-sectional study was conducted in rural areas of China, and 1,198 type 2 diabetic patients with complete data were recruited. Elevated ALT and AST levels were defined as >40 U/L. Prevalence of abnormal liver enzymes was analyzed and multivariable analysis was used to identify independent risk factors.Results10.3% and 6.1% diabetic patients had elevated ALT and elevated AST, respectively. The prevalence of elevated liver enzymes was gender-related; it was 13.8% in men and 7.5% in women for elevated ALT, and 7.4% in men and 3.1% in women for elevated AST. High triglyceride was positively associated with both elevated ALT (OR 1.80, 95% CI 1.08-3.01, p = 0.024) and elevated AST (OR 2.24, 95%CI 1.08-4.65, p = 0.031), while taking anti-diabetes medicine was inversely related to both elevated ALT (OR 0.48, 95% CI 0.29-0.80, p = 0.005) and elevated AST (OR 0.37, 95% CI 0.17-0.82, p = 0.014). The risk of elevated ALT in diabetic patients increased with the presence of obesity (OR 2.54, 95% CI 1.07-6.01, p = 0.034), and was lower in women (OR 0.37, 95% CI 0.19-0.72, p = 0.003). Hypertension (OR 4.33, 95% CI 1.41-13.30, p = 0.011), current drinking status (OR 2.90, 95% CI 1.21-6.96, p = 0.017) and national minority (OR 3.26, 95%CI 1.31-8.12, p = 0.011) were risk factors for elevated AST.ConclusionA relatively high prevalence of abnormal serum liver enzymes in diabetic patients was demonstrated in China, especially in males. More attention should be paid to preventing liver injuries in diabetic patients.

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