Elevated liver enzymes and comorbidities in type 2 diabetes: A multicentre analysis of 51 645 patients from the Diabetes Prospective Follow‐up (DPV) database

Abstract

AbstractAimTo assess the prevalence of elevated liver enzymes and associated diabetes‐related comorbidities in type 2 diabetes (T2D).Subjects and MethodsBetween 2010 and 2019, 281 245 patients with T2D (aged 18‐75 years) from 501 Diabetes Prospective Follow‐up (DPV) centres were evaluated, resulting in analysis of 51 645 patients with complete data on demographics and liver enzymes.ResultsElevated liver enzymes were found in 40.2% of all patients. However, only 8.6% of these patients had International Classification of Diseases‐10 codes for nonalcoholic fatty liver disease and/or nonalcoholic steatohepatitis. Adjusted for age, sex, diabetes duration, body mass index and glycated haemoglobin, a higher prevalence of arterial hypertension (P < 0.0001), dyslipidaemia (P < 0.0001), peripheral artery disease (P = 0.0029), myocardial infarction (P = 0.0003), coronary artery disease (P = 0.0001), microalbuminuria (P < 0.0001) and chronic kidney disease (P < 0.0001) was seen in patients with elevated versus normal liver enzymes. The prevalence of elevated liver enzymes was lowest in patients receiving sodium‐glucose cotransporter‐2 (SGLT2) inhibitors or a combination of SGLT2 inhibitors and glucagon‐like peptide‐1 receptor agonists.ConclusionElevated liver enzymes are common in patients with T2D and clearly correlate with a higher prevalence of clinically relevant comorbidities. Assessing liver enzymes should be standard clinical routine in T2D due to a possible predictive role for comorbidities and complications.