Abstract
Aim: Liver is the vital organ regarding energy metabolism. Alteration of liver enzymes may be one of the risk factor for altered glucose metabolism. This study aim is to analysis metamorphic changes in liver enzymes in prediabetic young adult subjects.
Methods: Total 400 subjects were taken, out of which 300 were diagnosed prediabetic subjects while 100 are normal healthy age and gender match controls (normoglycemic).The anthropometric parameters were measured by standard methods. The serum samples were used for glucose, AST, ALT, ALP and GGT estimation by mindray BS-400 autoanalyser. The plasma HbA1c estimated by boronate affinity chromatography.
Results: the prediabetic subjects had higher WC, WHR, BMI, blood pressure, serum AST, ALP and GGT as compared to normoglycemic subjects.
Conclusion: The altered liver enzymes (serum AST, ALP and GGT) may be associated with altered glucose homeostasis. Liver enzymes may be used as a cheap and reliable marker in prediabetes subjects. Proper and timely management of prediabetes may prevent the various complications which may appears in future.
Keywords: Prediabetes, liver enzymes, young adult, GGT, ALT.
References
- American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2018. Diabetes Care 2018;41(1):S13–S27.
- Bansal, N. Prediabetes diagnosis and treatment: A review. World J. Diabetes. 2015 March 15;6(2):296-303.
- Punthakee Z, Goldenberg R, Katz P. Definition, Classification and Diagnosis of Diabetes, Prediabetes and Metabolic Syndrome. Can J Diabetes 2018;42:S10–S15.
- Williams K H, Shackel N A, Gorrell M D, McLennan S V, Twigg S M. Diabetes and Nonalcoholic Fatty Liver Disease: A Pathogenic Duo, Endocrine Reviews, 2013 February 1;34(1): 84–129.
- Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: phase I results of the Indian Council of Medical Research- India Diabetes (ICMR-INDIAB) study. Diabetologia 2011;54(12):3022–7.
- Li C, Ford ES, Zhao G, Mokdad AH. Prevalence of pre-diabetes and its association with clustering of cardiometabolic risk factors and hyperinsulinemia among U.S. adolescents: national health and nutrition examination survey 2005–2006. Diabetes Care 2009;32(2):342–7.
- Cho, E.-H., Shin, D., Cho, K.-H., & Hur, J. Prevalences and Management of Diabetes and Pre-diabetes among Korean Teenagers and Young Adults: Results from the Korea National Health and Nutrition Examination Survey 2005–2014. Journal of Korean Medical Science 2017; 32(12):1984–1990.
- Tabák AG, Herder C, Rathmann W,Brunner EJ, Kivimäki M. Prediabetes: A high-risk state for developing diabetes. 2012 June 16; 379(9833):2279–2290.
- Qian Y, Lin Y, Zhang T, Bai J, Chen F, Zhang Y, et al. The characteristics of impaired fasting glucose associated with obesity and dyslipidaemia in a Chinese population. BMC Public Health 2010;10:139.
- Rui, L. Energy Metabolism in the Liver. Comprehensive Physiology. 2014;4(1):177–197.
- Gossain VV, Aldasouqi S. The challenge of undiagnosed pre-diabetes, diabetes and associated cardiovascular disease Review article. Int J Diabetes Mellitus. 2010;2:43–46.
- Al-Shafaee MA, Bhargava K, Al-Farsi YM, McIlvenny S, Al-Mandhari A, Al-Adawi S, et al. Prevalence of pre-diabetes and associated risk factors in an adult Omani population. Int J Diabetes Dev Ctries. 2011;31:166–73.
- Basu R, Barosa C, Jones J, Dube S, Carter R, Basu A et al. Pathogenesis of prediabetes: role of the liver in isolated fasting hyperglycemia and combined fasting and postprandial hyperglycemia. J Clin Endocrinol Metab. 2013;98(3):E409–E417.
- Alam DS, Talukder SH, Chowdhury M.A, Siddiquee AT, Ahmed S, Pervin S, Khan S, Hasan, K.; Koehlmoos, T.L.; Niessen, L.W. Overweight and abdominal obesity as determinants of undiagnosed diabetes and pre-diabetes in Bangladesh. BMC Obes. 2016;3-19.
- Bener A, Yousafzai MT, Darwish S, Al-Hamaq AO, Nasralla EA, Abdul-Ghani M. Obesity index that better predict metabolic syndrome: body mass index, waist circumference, waist hip ratio, or waist height ratio. J Obes 2013:269038.
- Ramya HS, Goutham AS, Pragyee D. Body mass index, waist hip ratio and body fat percentage as early predictors of pre-diabetes and pre-hypertension in adolescents. Curr Pediatr Res 2017;21(2): 327-34.
- Haghighatdoost F, Amini M, Feizi A, Iraj B. Are body mass index and waist circumference significant predictors of diabetes and prediabetes risk: Results from a population based cohort study? World Journal of Diabetes. 2017; 8(7):365–373.
- Reddy CT, Suryanarayana B, Siddeswari R, Sudarsi B, Manohar S. A study of correlation of body mass index, waist hip ratio and lipid profile in type II diabetes mellitus subjects. IJ Sci Res Publ 2015; 5(4).
- Midha, T.; Krishna, V.; Shukla, R.; Katiyar, P.; Kaur, S.; Martolia, D.S.; Pandey, U.; Rao, Y.K. Correlation between hypertension and hyperglycemia among young adults in india. World J. Clin. Cases2015;3:171–179.
- Carba DB, Bas IN, Gultiano SA, Lee NR, Adair LS. Waist circumference and the risk of hypertension and prediabetes among Filipino women. European journal of nutrition. 2013;52(2):825–32.
- Sahib AK, Sahu SK, Reddy KN. Prediabetes and hypertension. J Indian Med Assoc. 2007; 105(1):25-8.
- Jha S, Kumar S, Waghdhare S. Comparative analysis of metabolic profile between prediabetic andnormoglycemics. J Prev Cardiol. 2014;4(1):606-11.
- Nguyen QM, Srinivasan SR, Xu JH, Chen W, Hassig S, Rice J, et al. Elevated liver function enzymes are related to the development of prediabetes and type 2 diabetes in younger adults. The bogalusa heart study. Diabetes Care 2011; 34:2603-09.
- Rückert IM, Heier M, Rathmann W, Baumeister SE, Döring A, Meisinger C. Association between markers of fatty liver disease and impaired glucose regulation in men and women from the general population: The KORA-F4-Study. Plos one 2011;6 (8) e22932:1-11.
- Bonnet F, Ducluzeau PH, Gastaldelli A, Laville M, Anderwald CH, Konrad T. Liver enzymes are associated with hepatic insulin resistance, insulin secretion, and glucagon concentration in healthy men and women. Diabetes 2011 June;60:1660-7.
- Oka R, Aizawa T, Yagi K, Hayashi K, Kawashiri M, Yamagishi M: Elevated liver enzymes are related to progression to impaired glucose tolerance in Japanese men. Diabet Med. 2014 May;31(5):552-8. DOI: 10.1111/dme.12345.
- Ader M, Stefanovski D, Kim SP, Richey JM, Ionut V, Catalano KJ et al., Variable hepatic insulin clearance with attendant insulinemia is the primary determinant of insulin sensitivity in the normal dog. Obesity (Silver Spring). 2014 May;22(5):1238–45. DOI:10.1002/oby.20625.
- Qin G, Lu L, Xiao Y, Zhu Y, Pan W, Xu X, Shen S et al., A cross-sectional study of the relationship between serum liver enzymes level and the incidence of impaired fasting glucose in males and females. Med Sci Monit 2014; 20:1319-25.
- Fujita T and Narumiya S. Roles of hepatic stellate cells in liver inflammation: a new perspective. Inflammation and Regeneration 2016;36:1. DOI.org/10.1186/s41232-016-0005-6.
- Ichimori S, Shimoda S, Goto R, Matsuo Y, Maeda T, Furukawa N, Kawashima J, Kodama S, Sekigami T, Isami S, Nishida K, Araki E. Ezetimibe improves glucose metabolism by ameliorating hepatic function in Japanese patients with type 2 diabetes. J Diabetes Investig 2012;3:179-184 DOI: 10.1111/ j.2040-1124.2011.00147.x.
- Fan H, Pan Q, Xu Y, Yang X. Exenatide improves type 2 diabetes concomitant with non-alcoholic fatty liver disease. Arq Bras Endocrinol Metabol 2013;57: 702-8.
- Targher G, Day CP, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N Engl J Med 2010;363:1341-1350.
- Haus JM, Solomon TP, Marchetti CM, Edmison JM, Gonzalez F, Kirwan JP. Free fatty acid-induced hepatic insulin resistance is attenuated following lifestyle intervention in obese individuals with impaired glucose tolerance. J Clin Endocrinol Metab 2010;95:323–7.
- Kusminski CM, Shetty S, Orci L, Unger RH, Scherer PE. Diabetes and apoptosis: lipotoxicity. Apoptosis 2009;14:1484-95.
- Park K, Gross M, Lee DH, Holvoet P, Himes JH, Shikany JM et al., Oxidative stress and insulin resistance: the coronary artery risk development in young adults study. Diabetes Care2009;32:1302-07.
- Ravuri C, Svineng G, Pankiv S, Huseby NE. Endogenous production of reactive oxygen species by the NADPH oxidase complexes is a determinant of gamma-glutamyl transferase expression. Free Radic Res. 2011 May;45(5):600-10. DOI: 10.3109/10715762.2011.564164.
- Ko SH, Baeg MK, Han KD, Ko SH, Ahn YB. Increased liver markers are associated with higher risk of type 2 diabetes. World J Gastroenterol 2015;21(24):7478-87.
- Esser N, Legrand-Poels S, Piette J, Scheen AJ, Paquot N. Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes. Diabetes Res Clin Pract 2014; 105: 141-50.
- Hossain IA, Rahman Shah MM, Rahman MK, Ali L. Gamma glutamyl transferase is an independent determinant for the association of insulin resistance with nonalcoholic fatty liver disease in Bangladeshi adults: Association of GGT and HOMA-IR with NAFLD. Diabetes and Metabolic Syndrome: Clinical Research and Reviews.2016;10:S25-S29. [PMID: 26482965]. DOI: 10.1016/j.dsx.2015.09.005
- Yu JH , Kim JS, Lee MR, Yoon SY, Cho SY, Yoo SH. Risks of borderline liver enzyme abnormalities to the incidence of impaired fasting glucose and diabetes mellitus: A 7 year follow up study of workers. Ann Occup Environ Med. 2016; 28:18. DOI 10.1186/s40557-016-0105-4.
Corresponding Author
Ashish Kumar Sharma
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.