Published August 30, 2025 | Version v1

Prevalence of Liver Function Test Abnormality and Associated Factors in Type 2 Diabetes Mellitus: A Comparative Cross-Sectional Study

  • 1. Senior Resident, MBBS, MD (Biochemistry), Department of Biochemistry, Raiganj Government Medical College and Hospital, Raiganj, West Bengal 733134
  • 2. Professor and Head of the Department, MBBS, MD (Medicine), Department of Medicine, In
  • 3. Medical Officer In-Charge, MBBS, Jatradanga Primary Health Centre, Jatradanga, Old Malda,West Bengal 732141

Description

Introduction: Type 2 diabetes mellitus (T2DM) is associated with a variety of hepatic abnormalities, ranging 
from non-alcoholic fatty liver disease (NAFLD) to advanced fibrosis, often reflected by alterations in liver 
function tests (LFTs). Early detection of such abnormalities is important for comprehensive management and 
prevention of complications. 
Objectives: To determine the prevalence of liver function test abnormalities in patients with T2DM and to 
identify associated clinical and biochemical factors, compared with non-diabetic controls. 
Methods: This comparative cross-sectional study was conducted over a period of one year at Raiganj 
Government Medical College and Hospital. A total of 100 adult patients diagnosed with type 2 diabetes mellitus 
attending the outpatient department were enrolled. The study variables included demographic factors such as 
age, sex distribution (male and female), duration of diabetes, and body mass index (BMI). Laboratory 
parameters assessed, comprised glycosylated hemoglobin (HbA1c) and liver function tests including alanine 
aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin, and albumin 
levels. Data were collected through patient interviews, clinical examinations, and biochemical investigations. 
The aim was to compare liver function parameters and their association with glycemic control and diabetes 
duration among type 2 diabetic patients. 
Results: Liver function test abnormalities are common in patients with type 2 diabetes mellitus, with elevated 
ALT and AST levels observed in 38% and 34% of patients, respectively. These abnormalities were significantly 
associated with poor glycemic control and higher BMI. Patients with HbA1c ≥7% had significantly higher ALT 
and AST levels and lower albumin compared to those with better glycemic control. Additionally, the prevalence 
of elevated liver enzymes increased progressively with higher BMI categories. Multivariate analysis identified 
male sex, longer diabetes duration (≥5 years), overweight/obesity (BMI ≥25 kg/m²), and poor glycemic control 
as independent risk factors for liver dysfunction, with poor glycemic control being the strongest predictor. 
Conclusion: LFT abnormalities are common in patients with T2DM and are associated with obesity, longer 
disease duration, poor glycemic control, and dyslipidemia. Routine monitoring of liver enzymes in T2DM 
patients may help in early identification and management of underlying hepatic disorders. 

Abstract (English)

Introduction: Type 2 diabetes mellitus (T2DM) is associated with a variety of hepatic abnormalities, ranging 
from non-alcoholic fatty liver disease (NAFLD) to advanced fibrosis, often reflected by alterations in liver 
function tests (LFTs). Early detection of such abnormalities is important for comprehensive management and 
prevention of complications. 
Objectives: To determine the prevalence of liver function test abnormalities in patients with T2DM and to 
identify associated clinical and biochemical factors, compared with non-diabetic controls. 
Methods: This comparative cross-sectional study was conducted over a period of one year at Raiganj 
Government Medical College and Hospital. A total of 100 adult patients diagnosed with type 2 diabetes mellitus 
attending the outpatient department were enrolled. The study variables included demographic factors such as 
age, sex distribution (male and female), duration of diabetes, and body mass index (BMI). Laboratory 
parameters assessed, comprised glycosylated hemoglobin (HbA1c) and liver function tests including alanine 
aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin, and albumin 
levels. Data were collected through patient interviews, clinical examinations, and biochemical investigations. 
The aim was to compare liver function parameters and their association with glycemic control and diabetes 
duration among type 2 diabetic patients. 
Results: Liver function test abnormalities are common in patients with type 2 diabetes mellitus, with elevated 
ALT and AST levels observed in 38% and 34% of patients, respectively. These abnormalities were significantly 
associated with poor glycemic control and higher BMI. Patients with HbA1c ≥7% had significantly higher ALT 
and AST levels and lower albumin compared to those with better glycemic control. Additionally, the prevalence 
of elevated liver enzymes increased progressively with higher BMI categories. Multivariate analysis identified 
male sex, longer diabetes duration (≥5 years), overweight/obesity (BMI ≥25 kg/m²), and poor glycemic control 
as independent risk factors for liver dysfunction, with poor glycemic control being the strongest predictor. 
Conclusion: LFT abnormalities are common in patients with T2DM and are associated with obesity, longer 
disease duration, poor glycemic control, and dyslipidemia. Routine monitoring of liver enzymes in T2DM 
patients may help in early identification and management of underlying hepatic disorders. 

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Dates

Accepted
2025-08-14