In:
Diabetes, Obesity and Metabolism, Wiley, Vol. 19, No. 8 ( 2017-08), p. 1171-1178
Abstract:
To assess the prevalence of elevated liver enzymes in adults with type 1 diabetes mellitus ( T1DM ) in routine clinical care and the association with cardiovascular risk profile in the D iabetes‐ P rospective‐ D ocumentation ( DPV ) network in G ermany and A ustria. Subjects and methods This cross sectional observational study from the DPV registry includes data from 45 519 adults with T1DM at 478 centres up to S eptember 2016. Liver enzyme measurements were available in 9226 (29%) patients at 270 centres and were analysed for increased alanine aminotransferase ( ALT ; men 〉 50 U/L , women 〉 35U / L ) and/or aspartate aminotransferase ( AST ; men 〉 50 U/L , women 〉 35U / L ) and/or gamma‐glutamyltransferase ( GGT ; men 〉 60U / L , women 〉 40 U/ L ). A subgroup analysis in patients for whom 2 or more ALT measurements were available (n = 2335, 25%) and whose ALT was increased at least twice (men 〉 30 U/L , women 〉 19U /L) was performed. Associations with glycaemic control, cardiovascular risk factors and late complications were investigated with multiple regression analyses. Results Twenty percent (19.8%, n = 1824) had increased liver enzyme(s) on one or more occasions. Increased liver enzymes were associated with worse glycaemic control and higher BMI (both P 〈 .0001), dyslipidemia ( OR , 1.75; 95% CI , 1.54‐2.0), hypertension (OR, 1.48; 95% CI: 1.31‐1.68), myocardial infarction (OR, 1.49; 95% CI , 1.17‐1.91) and end stage renal disease (OR, 1.59; 95% CI , 1.17‐2.17). ALT was increased twice in 29% and was associated with worse glycaemic control ( P 〈 .0001), higher BMI ( P 〈 .0001), hypertension ( OR , 1.58; 95% CI , 1.26‐1.97) and dyslipidemia ( OR , 1.89; 95% CI , 1.51‐2.37). Conclusions In this clinical audit in adults with T1DM , elevated liver enzymes on routine assessment were associated with a less favourable cardiovascular risk profile and with poorer glycaemic control.
Type of Medium:
Online Resource
ISSN:
1462-8902
,
1463-1326
DOI:
10.1111/dom.2017.19.issue-8
Language:
English
Publisher:
Wiley
Publication Date:
2017
detail.hit.zdb_id:
2004918-3
