Insulin resistance and hepatic markers in type 2 diabetes mellitus: a cross-sectional study

Abstract

Aim: The objective of this study was to compare liver markers and insulin resistance between diabetic and non-diabetic individuals and determine the correlation between diabetic and non-diabetic parameters. Methods: A cross-sectional study was conducted at the Department of Biochemistry after being approved by the Institutional Ethics Committee. Fasting venous blood was collected for serum analysis of various biochemical parameters, including liver enzymes AST and ALT. Total and direct bilirubin and plasma proteins like total protein, albumin, globulin, A:G ratio were assessed using automated chemistry analyzers. Insulin levels were measured using a hormone analyzer based on electrochemiluminescence. Insulin resistance was calculated using the homeostasis model assessment (HOMA-IR) formula, and PON1 activity was determined using a spectrophotometric method. Results: The study showed a significant increase in the levels of insulin, liver enzymes, bilirubin, and insulin resistance in T2DM patients compared to controls. Notably, AST and ALT exhibited excellent discriminatory ability as liver markers, with perfect AUC values, while PON1 showed lower AUC values, indicating its limited utility as a liver marker in T2DM. Positive correlations were observed between PON1 and HOMA-IR, as well as between PON1 and insulin levels. These findings suggest that while liver enzymes like AST and ALT are robust markers of liver disease in T2DM, PON1 may not be as effective in predicting liver disease in this population. Conclusion: The study provides valuable insights into the association between liver markers and insulin resistance in type 2 diabetes mellitus (DM), highlighting the importance of comprehensive liver function assessment in diabetic individuals.