Diabetes Care, Vol 7, Issue 3 248-254, Copyright © 1984 by American Diabetes Association
Liver function tests in diabetic patients
PI Salmela, EA Sotaniemi, M Niemi and O Maentausta
Nine different liver function tests (LFT) were assessed in 175 unselected
diabetic outpatients stabilized on diet, insulin, or oral hypoglycemic
drugs. In another group of 72 diabetic inpatients having diagnostic liver
biopsy, relationships between LFT and histologic changes in the liver were
investigated. Abnormalities in at least one of the tests were noted in 57%
of the outpatients, and two tests gave pathologic results in 27%. The
non-insulin-dependent diabetic patients more often had abnormal LFT results
than did the insulin-dependent diabetic patients. Serum chenodeoxycholic
acid concentrations were increased in 27%, gamma-glutamyl transpeptidase
(gGT) activities in 19%, and alanine aminotransferase (Alt) activities in
17% of the outpatients, but the increases were rarely more than twice the
upper limit of normal. In multivariate analysis, outpatients who were
overweight, showed poor diabetes control during a short duration of
diabetes controlled by treatment with diet or oral agents, and had a mature
age at onset of diabetes displayed the most significant clinical
explanatory variables associated with abnormal Alt. In the inpatients, the
percentages of abnormal Alt and gGT results were augmented, along with
increasing severity of histologic changes, but the mean values of Alt and
gGT did not differ significantly between the various histologic groups. In
addition, the diabetic patients with nonspecific inflammatory changes or
increase in liver fibrosis often showed normal or only minor elevations in
these test values.