The significance of Liver Function Tests in detecting prediabetes as a prognostic factor

Abstract

Prediabetes has been a target for research to understand risk factors that may predict it. The presence of liver function enzymes is one of the risk factors (alanine aminotransferase [ALT], aspartate aminotransferase [AST], and alkaline phosphatase [ALP]). Therefore, the aim of present cross-sectional investigation was to determine the predictive relevance of three enzymes in the development of prediabetes in Iraqi adults. Three groups of individuals have included: 30 apparently healthy individuals (normoglycemia), 58 prediabetics, and 30 patients who suffer from type 2 diabetes mellitus (T2DM). Results revealed that ALT median was significantly increased in prediabetes compared to normoglycemia and diabetes (19.7 vs. 13.3 and 12.0 IU/L, respectively; p = 0.001). For AST, there were no significant differences between the three groups investigated (p = 0.444). In the case of ALP, significantly increased medians were observed in prediabetes and diabetes compared to normoglycemia (90.4 and 87.5 vs. 70.6 IU/L, respectively; p = 0.007). ROC curve analysis revealed that ALT (AUC = 0.791; 95% CI =0.688 - 0.894; p = 0.001; cut-off value = 16.1IU/L; sensitivity = 72.4%; specificity = 73.3%) and ALP (AUC = 0.724; 95% CI = 0.621 - 0.828; p = 0.001; cut-off value = 80.2 IU/L; sensitivity = 67.2%; specificity = 66.7%) were good predictors in differentiating between prediabetes and normoglycemia. In diabetes, both variables failed to show such prediction, and there was no significant differentiating power. Logistic regression analysis confirmed the significance of ALT and ALP in prediabetes. An OR of 7.22(95% CI = 2.71 - 19.22; p = 0.001) was related with ALT. ALP was also linked to a higher incidence of prediabetes A greater frequency of prediabetes was also associated to ALP (OR = 5.38; 95 percent CI = 2.01 - 14.38; p = 0.001). In the case of diabetes, ALT and ALP were not linked to a higher risk of developing the condition. To summarize, this research shows that ALT and ALP are effective predictors of prediabetes, but further research is needed to fully comprehend the mechanism underlying the link between liver function enzymes and diabetes risk.