Summary:
Objectives: Clinical evaluation and identification of
aetiology of asymptomatic raised serum alanine
aminotransferase (ALT) level in newly detected adult diabetic
and impaired glucose tolerance (IGT) patients.
Methods: In this cross-sectional study, newly detected adult
diabetic and IGT patients having asymptomatic raised serum
ALT level of > 1.5 times of upper limit of normal were
evaluated clinically and by laboratory tests.
Results: Total number of patients was 120, which was 3.1%
of all newly registered diabetic and IGT patients over the
study period. Male were 74 and female 46. Diabetes mellitus
(DM) was found in 93.3% cases and IGT in 6.7%. Mean
age was 43.1 years, mean body weight was 64.5 kg and mean
body mass index (BMI) was 25.5 kg/m2. Central (abdominal)
obesity was found in 61.5% cases. Increased waist hip ratio
was found in 86.3% cases. Hypertension and hepatomegaly
were present in 35% and 5.8% cases respectively.
Dyslipidaemia was found in 98.3% cases and 45% patients
fulfilled criteria for metabolic syndrome. Regarding etiology,
76.7% cases had non-alcoholic fatty liver disease (NAFLD),
8.3% had HBsAg sero-positivity, 4.2% had anti-HCV seropositivity
and 3.3% had both NAFLD and HBsAg seropositivity.
In 7.5% cases no cause was found. Raised serum
ALT level had a significant correlation with metabolic
syndrome (p= 0.016) and increasing age (p= 0.008).
Conclusion: Elevation of serum ALT is common in DM
and IGT. NAFLD is the commonest cause followed by
hepatitis B and C virus infection.
Keywords: alanine aminotransferase, asymptomatic, diabetes
mellitus, impaired glucose tolerance, non-alcoholic fatty
liver disease.
(J Banagladesh Coll Phys Surg 2015; 33: 70-74)