Prevalence of Liver Function Test Abnormality and Associated Factors in Type 2 Diabetes Mellitus: A Comparative Cross-Sectional Study

Introduction: Type 2 diabetes mellitus (T2DM) is associated with a variety of hepatic abnormalities, ranging from non-alcoholic fatty liver disease (NAFLD) to advanced fibrosis, often reflected by alterations in liver function tests (LFTs). Early detection of such abnormalities is important for comprehensive management and prevention of complications. Objectives: To determine the prevalence of liver function test abnormalities in patients with T2DM and to identify associated clinical and biochemical factors, compared with non-diabetic controls. Methods: This comparative cross-sectional study was conducted over a period of one year at Raiganj Government Medical College and Hospital. A total of 100 adult patients diagnosed with type 2 diabetes mellitus attending the outpatient department were enrolled. The study variables included demographic factors such as age, sex distribution (male and female), duration of diabetes, and body mass index (BMI). Laboratory parameters assessed, comprised glycosylated hemoglobin (HbA1c) and liver function tests including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin, and albumin levels. Data were collected through patient interviews, clinical examinations, and biochemical investigations. The aim was to compare liver function parameters and their association with glycemic control and diabetes duration among type 2 diabetic patients. Results: Liver function test abnormalities are common in patients with type 2 diabetes mellitus, with elevated ALT and AST levels observed in 38% and 34% of patients, respectively. These abnormalities were significantly associated with poor glycemic control and higher BMI. Patients with HbA1c ≥7% had significantly higher ALT and AST levels and lower albumin compared to those with better glycemic control. Additionally, the prevalence of elevated liver enzymes increased progressively with higher BMI categories. Multivariate analysis identified male sex, longer diabetes duration (≥5 years), overweight/obesity (BMI ≥25 kg/m²), and poor glycemic control as independent risk factors for liver dysfunction, with poor glycemic control being the strongest predictor. Conclusion: LFT abnormalities are common in patients with T2DM and are associated with obesity, longer disease duration, poor glycemic control, and dyslipidemia. Routine monitoring of liver enzymes in T2DM patients may help in early identification and management of underlying hepatic disorders.