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Horm Metab Res 2018; 50(05): 397-402
DOI: 10.1055/a-0603-7899
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

The Relationship Between Liver Enzymes and Insulin Resistance in Type 2 Diabetes Patients with Nonalcoholic Fatty Liver Disease [*]

Xia Sheng   #
1   Department of Endocrinology and Metabolism, Second Affiliated Hospital of Harbin Medical University, Harbin, China
,
Hui Che   #
2   Department of Endocrinology and Metabolism, Harbin Medical University, Harbin, China
,
Qingming Ji
3   Department of Spinal Surgery, First Hospital of Jilin University, Changchun, China
,
Fan Yang
1   Department of Endocrinology and Metabolism, Second Affiliated Hospital of Harbin Medical University, Harbin, China
,
Jie Lv
1   Department of Endocrinology and Metabolism, Second Affiliated Hospital of Harbin Medical University, Harbin, China
,
Yueqiu Wang
1   Department of Endocrinology and Metabolism, Second Affiliated Hospital of Harbin Medical University, Harbin, China
,
Huimin Xian
1   Department of Endocrinology and Metabolism, Second Affiliated Hospital of Harbin Medical University, Harbin, China
,
Lihong Wang
1   Department of Endocrinology and Metabolism, Second Affiliated Hospital of Harbin Medical University, Harbin, China
› Author Affiliations
Further Information

Publication History

received 19 September 2017

accepted 05 April 2018

Publication Date:
03 May 2018 (online)

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Abstract

Non-alcoholic fatty liver disease (NAFLD) is prevalent worldwide, especially in patients with type 2 diabetes. Liver enzymes are the main warning signs of liver injury and insulin resistance (IR) is critical to NAFLD. This study was aimed to investigate the association between liver enzymes and insulin resistance in type 2 diabetes patients with NAFLD. Data from 212 diabetes patients with NAFLD were analyzed, including 118 males and 94 females who received care from 2014 to 2015. The patients were divided into three groups by severity (mild n=87, moderate n=89, severe n=36). All patients underwent standard clinical and laboratory examinations. Liver enzymes including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γ-glutamyl transferase (GGT) were measured, serum fasting glucose and serum fasting insulin were obtained. IR was assessed using the homeostasis model assessment insulin resistance index (HOMA-IR). Age, sex, and BMI did not significantly differ in patients (p>0.05). Compared with normal levels, elevated ALT and AST were associated with a higher HOMA-IR (p=0.0035, p=0.0096, respectively). HOMA-IR did not significantly differ (p>0.05) between patients with normal and elevated GGT. HOMA-IR increased as the levels of liver enzymes increased, and each enzyme showed a significant association with HOMA-IR (p=0.0166, p<0.0001, and p <0.0001). HOMA-IR differs between normal and elevated ALT and AST. Liver enzymes are associated with HOMA-IR in type 2 diabetes patients with NAFLD. These findings can help evaluate the degree of IR and hepatocellular steatosis in patients and prevent the progression of type 2 diabetes and NAFLD in clinical practice.

Key words

non-alcoholic fatty liver disease (NAFLD) - type 2 diabetes - insulin resistance (IR) - alanine aminotransferase (ALT) - aspartate aminotransferase (AST) - γ-glutamyl transferase (GGT)

* The investigations were carried out in the Second Affiliated Hospital of Harbin Medical University, Harbin, China


# These authors contributed equally to the manuscript


 

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