Clinicopathological features of liver injury in patients with type 2 diabetes mellitus and comparative study of histologically proven nonalcoholic fatty liver diseases with or without type 2 diabetes mellitus.
Study Goal
The researchers aimed to investigate the clinicopathological features of liver injury, including the role of elevated serum alanine aminotransferase (ALT) levels, in diabetes mellitus (DM) patients, particularly focusing on nonalcoholic fatty liver disease (NAFLD).
Results Summary
The study found that 28.6% of DM patients had elevated serum ALT levels (≥31 IU/L), with alcohol consumption having no significant effect on ALT levels. Among NAFLD patients, male DM patients showed higher frequencies of NASH and advanced-stage NASH compared to non-DM males.
Population
Japanese patients with diabetes mellitus (DM) and histologically proven nonalcoholic fatty liver disease (NAFLD).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
- | neutral | HBsAg and anti-HCV Ab positivity rates | Japanese DM patients | 1.7 and 5.1 % | Positivity rates for Hepatitis B surface antigens (HBsAg) and anti-hepatitis C virus antibodies (anti-HCV Ab) were | #1 |
- | neutral | proportion of drinkers | DM patients | 14.9 and 4.3 % | The proportion of drinkers consuming 20-59 g and ≥60 g alcohol daily was | #2 |
- | increase | serum ALT levels | DM patients | 28.6 % | The percentage of DM patients with elevated serum alanine aminotransferase (ALT) levels (≥31 IU/L) was | #3 |
Alcohol consumption | no change | serum ALT levels | DM patients | no significant effect | had no significant effect on | #4 |
- | no change | serum HBV-DNA | HBsAg-positive patients | 72% | Seventy-two percent of HBsAg-positive patients were serum hepatitis B virus (HBV)-DNA negative | #5 |
- | increase | serum HBV-DNA levels | HBsAg-positive patients | 10 % | 10 % exhibited high levels of the same (>4.0 log copies/ml) | #6 |
- | no change | serum HCV-RNA | anti-HCV Ab-positive patients | 38 % | Thirty-eight percent of anti-HCV Ab-positive patients were serum HCV-RNA negative | #7 |
- | increase | frequencies of NASH and advanced stage NASH | male DM patients | significantly higher | the frequencies of NASH and advanced stage NASH were significantly higher in | #8 |
BACKGROUND: The Japan Society of Diabetes Mellitus reported that the leading cause of death in patients with diabetes mellitus (DM) was chronic liver disease; however, there are limited studies investigating the cause of liver injury in these patients. Our study aimed to clarify the clinicopathological features of liver injury and the characteristics of nonalcoholic fatty liver disease (NAFLD) in DM patients. METHODS: In total, 5,642 DM patients and 365 histologically proven NAFLD patients were enrolled. Clinical and laboratory parameters and liver biopsy results were, respectively, recorded and analyzed for the two sets of patients. RESULTS: Positivity rates for Hepatitis B surface antigens (HBsAg) and anti-hepatitis C virus antibodies (anti-HCV Ab) were 1.7 and 5.1 %, respectively. The proportion of drinkers consuming 20-59 g and ≥60 g alcohol daily was 14.9 and 4.3 %, respectively. The percentage of DM patients with elevated serum alanine aminotransferase (ALT) levels (≥31 IU/L) was 28.6 %. Alcohol consumption had no significant effect on serum ALT levels. Seventy-two percent of HBsAg-positive patients were serum hepatitis B virus (HBV)-DNA negative, whereas 10 % exhibited high levels of the same (>4.0 log copies/ml). Thirty-eight percent of anti-HCV Ab-positive patients were serum HCV-RNA negative. Among the NAFLD patients, the frequencies of NASH and advanced stage NASH were significantly higher in male DM patients than in male patients without DM. CONCLUSIONS: Although HBsAg- and anti-HCV Ab-positivity rates were high in our Japanese DM patients, a majority of liver injuries could be associated with NAFLD/nonalcoholic steatohepatitis.