Correlation of hepatic transaminases with cortisol levels in type 2 diabetes
DOI:
https://doi.org/10.51248/.v43i4.2734Keywords:
Type 2 diabetes mellitus, hepatic transaminases, aspartate aminotransferase, alanine amino transferase, NAFLD, cortisol, subclinical hypercortisolismAbstract
Introduction and Aim: Aminotransferases are the markers of liver function and cortisol is the hyperglycemic stress hormone, both have been associated with insulin resistance and type 2 diabetes. Hypothalamic pituitary adrenal axis is known to control many functions of the liver. This study was aimed to evaluate the correlation of cortisol with hepatic transaminases; AST and ALT also with fasting blood glucose (FBG) and HbA1c in type 2 diabetic patients. Also, the AST, ALT and cortisol levels of participants were compared based on their diabetic duration and gender.
Materials and Methods: This prospective study included patients with type 2 diabetes (n=89) with a mean diabetic duration of 7.66± 6.871 years, of which 66.3% were males and 33.7% were females. Data for the above parameters except cortisol were collected from the data management system of the central lab. Morning serum cortisol levels were estimated by enzyme-linked immunosorbent assay (ELISA) method. Karl Pearson’s correlation coefficient and independent student’s t-test were applied to find correlation and comparison of AST, ALT and cortisol levels of participants based on their diabetic duration and gender respectively.
Results: The comparison based on diabetic duration shows significant differences (p<0.005) with AST while, not with ALT and cortisol. Also, they did not show a significant difference in either of the gender. Among hepatic transaminases, the probability of association of ALT with FBS levels and HbA1c levels was significant (p<0.05). However, though a positive trend is seen in the AST association, there is no strong correlation observed. Likewise, the association of serum cortisol levels, with AST, ALT and HbA1c was not significant but the probability of association was significant with FBS levels.
Conclusion: Findings from the present study suggest that liver transaminases are positively correlated with serum cortisol levels in type 2 diabetic patients.
References
Alhussona, A. J., Al-Musawi, A. H., Jalood, H. H., Hamzah, S. S. A study of ATPase gene variants of mitochondrial DNA in patients with Type 2 diabetes mellitus. Biomedicine. 2023 Feb 26;43(1):225-229.
Suvarna, R., Biswas, M., Shenoy, R. P., Prabhu, M. M. Association of clinical variables as a predictor marker in type 2 diabetes mellitus and diabetic complications. Biomedicine. 2023 Mar 28;43(01):335-340.
Galicia, G.U., Benito,V. A., Jebari, A., Larrea, S.A., Siddiqi, H.,Uribe, K.B., et al., Pathophysiology of Type 2 Diabetes Mellitus. International Journal for Molecular Sciences. 2020 Aug;21(17):62-75.
Abro, M.U. R., Butt, A., Baqa, K., Waris, N., Khalid, M., Fawwad, A. Association of serum liver enzyme Alanine Aminotransferase (ALT) in patients with type 2 diabetes. Pak J Med Sci. 2018 Aug; 34(4):839-843.
Tanase, D.M., Gosav, E.M., Costea, C.F., Ciocoiu, M., Lacatusu, C.M., Maranduca ,M.A., et al., The Intricate Relationship between Type 2 Diabetes Mellitus (T2DM), Insulin Resistance (IR), and Nonalcoholic Fatty Liver Disease (NAFLD). Jia G, editor. Journal of Diabetes Research. 2020 Aug 4;2020:3920196.
Mohamed, J., Nazratun, N.A.H., Zariyantey, A.H., Budin, S.B. Mechanisms of Diabetes-Induced Liver Damage: The role of oxidative stress and inflammation. Sultan Qaboos Univ Med J. 2016 May;16(2):e132-e141.
Elizabeth, H.H. Elevated Liver Function Tests in Type 2 Diabetes. Clinical Diabetes. 2005 Jul;23(3):115-119.
Chiodini, L., Torlontano, M., Scillitani, A., Arosio, M., Bacci, S.,Lembo, S.D., et al., Association of subclinical hyper cortisolism with type 2 diabetes mellitus: a case-control study in hospitalized patients. European Journal of Endocrinology. 2005 Dec;153(6):837-844.
Tsai, M.H., Peng,Y.S., Chen,Y.C., Liu, N.J.,Ho,Y.P., Fang,J.T., et al., Adrenal insufficiency in patients with cirrhosis, severe sepsis and septic shock Hepatology, 43 (2006), pp. 673-681.
Fernández, J., Escorsell, A., Zabalza, M., Felipe, V., Navasa, M., Mas, A., et al., Adrenal insufficiency in patients with cirrhosis and septic shockHepatology, 44 (2006), pp. 1288-1295.
Cobbina, E., Akhlaghi, F. Non-Alcoholic Fatty Liver Disease (NAFLD) - Pathogenesis, Classification, and Effect on Drug Metabolizing Enzymes and Transporters. Drug Metabolism Reviews. 2017;49(2):197-211.
Kharb,S., Garg,M.K., Pankaj,P., Bhaskar,N., Karninder, S.B., Abhay, G., et al., Assessment of adrenal function in liver diseases. Indian Journal of Endocrinology and Metabolism. 2013 Jun;17(3):465-471.
Ari, L., Orna, Z. S., Ruth, F., John, G.L., Aron,W. Measuring cortisol in human psychobiological studies. Physiology and Behavior. 2007;90(1):43-53.
Oltmanns, K. M., Dodt, B., Schultes, B., Raspe, H. H., Schweiger, U. Cortisol correlates with metabolic disturbances in a population study of type 2 diabetic patients. European Society of Endocrinology. 2006 Feb;154(2):325-331.
Reynolds, R.M., Strachan, M. W. J., Labad, J., Lee, A.J., Frier, B.M., Fowke, G., et al., Morning Cortisol Levels and Cognitive Abilities in People With Type 2 Diabetes. Diabetes Care. 2010 Apr;33(4):714-720.
Chiodini, L., Adda, G., Scillitan, A., Coletti, F., Morelli,V., Lembo, S. D., et al., Cortisol secretion in patients with type 2 diabetes relationship with chronic complications. Diabetes Care. 2007 Jan; 30(1):83-88.
Alzahrani, S. H., Baig, M., Bashawri, J .I., Aashi, M. M., Shaibi, F. K., Alqarni, D. A. Prevalence and Association of Elevated Liver Transaminases in Type 2 Diabetes Mellitus Patients in Jeddah, Saudi Arabia. Cureus. 2019 Jul 18;11(7).
Mathur, S., Mehta, D. K., Kapoor, S., Yadav, S. Liver Function in Type-2 Diabetes Mellitus Patients. International Journal of Scientific Study. 2016 Jan; 3(10):43-47.
Meybodi, M. A., Ardekani, M. A., Rashidi, M. Prevalence of abnormal serum alanine transaminase levelsin type 2 diabetic patients in Iran. Pakistan Journal of Biological Science. 2008;11(8):2274-2277.
Ko, S. H., Baeg, M. K., Han, K. D., Ahn, Y.B. Increased liver markers are associated with higher risk of type 2 diabetes. World J Gastroenterol. 2015 Jun 28;21(4):7478-7487.
Dahman, L. S. B., Humam, M. A., Musiaan, N. S., Daakik, A.M., Balfas, M. A. Elevated Liver Enzymes and its Association with Type Two Diabetes Mellitus: The Occurrence in Yemeni Population. Int J Endocrinol Metab Disord. 2021 Apr 15;7(1).
Bora, K., Borah, M., Chutia, H., Nath, C.K., Ruram, A. A., Das, D. Presence of concurrent derangements of liver function tests in type 2 diabetes and their relationship with glycemic status: A retrospective observational study from Meghalaya. J Lab Physicians. 2016 Feb 14;8(1):30-35.
Sunitha, S., Rajeev, G., Wilma, D.S.C.R., Rao, S. Evaluation of significance of liver enzymes as screening tests for the early detection of clinically asymptomatic non-alcoholic fatty liver disease in type 2 diabetes mellitus patients. International Journal of Biomedical and Advance Research. 2015;6(12):860-863.
Al-Jameil, N., Khan, F. A., Arjumand, S., Khan, M. F., Tabassum, H. Associated liver enzymes with hyperlipidemic profile in type 2 diabetes patients. Int J Clin Exp Pathol. 2014 Jun 15;7(7):4345-4349.
Joseph, J. J., Golden, S. H. Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus. Annal of the New York Academy of Science. 2016;1391(1):20-34.
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