Determinants of Abnormal Liver Function Tests in Diabetes Patients in Myanmar

Abnormal liver function tests are not uncommon encounter in diabetes mellitus patients. The aim of this study was to find out the liver function test abnormalities in a group of diabetic patients in Myanmar and to determine the factors associated with these biochemical changes. In this cross sectional study conducted at the diabetic clinic of Yangon General Hospital, Myanmar between March 2006 and February 2007, a total of 81 patients were included. The means of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ glutamyl transferase (γ GT), bilirubin and prothrombin time fall within normal range. Raised ALT and AST were noted in 18.5% and 14.8% respectively. 4.9% had high bilirubin and prolonged prothrombin time each, γGT was normal in all patients. The mean values of ALT and AST had no significant correlation with age, family history of diabetes, mode of therapy or type of diabetes. Although mean ALT had no correlation with gender of the diabetes patients, AST was found to be significantly elevated in men. Values of ALT and AST were also significantly higher with increasing BMI. Hepatomegaly, increased liver echogenicity and presence of fatty liver were the factors significantly correlated with elevated ALT and AST values. In conclusion, abnormal liver function results are more common among diabetes patients. Elevated ALT and AST are the markers for associated non alcoholic fatty liver disease in diabetes patients. Testing for ALT and AST, should be carried out to screen underlying fatty liver, especially in male diabetes patients with high BMI.