Lack of correlation between serum alanine amino transferrase and abdominal ultrasound in the diagnosis non alcoholic fatty liver disease in type 2 diabetes

Abstract

Non alcoholic fatty liver disease (NAFLD) and type II diabetes (DM II) are increasingly recognized. Screening of DM II patients for NAFLD includes serum alanine amino transferase (ALT) and abdominal ultrasound (US). A retrospective cohort study was used to examine the sensitivity of serum ALT in the diagnosis of NAFLD in type 2 DM patients when compared to abdominal ultrasound and to determine the predictive factors of serum ALT in type 2 DM patients. Patient's age, sex, and history of hypertension (HTN), hyperlipidemia, height and weight were obtained from type 2 DM patients attending Out-patient Clinics. The body mass index (BMI) was also measured. Then retrospectively, we collected results of liver function tests, fasting lipids and abdominal US. Out of the 72 patients (30 males, 42 females; mean age: 58.49), 38.9% had hyperlipidemia, 59.7 % had HNT. The mean BMI was 29.97. Females were more obese and morbidly obese compared to males (p  0.001). 69 patients had normal serum ALT. Mean serum ALT for males was 39.29 U/L (95% CI 33.5-45.07) and the value for females was 30.9U/L (95% CI 33.55-36.2). The difference between the values in male and females was statistically significant (p  0.033). The serum ALT in type 2 DM obese and morbidly obese patients was significantly (p  0.034) higher than that of normal and overweight patients. 55.6% had NAFLD by US. ALT was not different in patients with US diagnosed NFLD from those without. HTN significantly increased the risk for NAFLD (p  0.018). In conclusion, serum ALT correlates poorly with abdominal US in the diagnosis of NAFLD in type 2 diabetic patients. Sex and BMI significantly influence serum ALT in type 2 DM patients.