Evaluation of Liver Biomarkers among Type Two Diabetic Patients with and without Chronic Kidney Disease Attending Jimma Medical Center, Jimma southwest, Ethiopia, 2023

Abstract

Background: - Diabetes mellitus is an abnormal metabolic condition manifested by high blood sugar levels resulting from defective insulin action or, secretion, or both. Liver disorder is known to be one of the risk factors for diabetes and diabetics are known to be prone to both liver and kidney disorders. But, the association between these diseases is not well studied. Objective: The study was aimed to evaluate liver biomarkers and their associated factors among T2D patients with CKD and T2D without CKD attending JMC from November 01, 2022 to January 20, 2023. Materials and Methods: - An institutional -based comparative cross-sectional study design was implemented at Jimma Medical Center from November 01, 2022 to January 20, 2023. Consecutive sampling technique was implemented to gather the data. The data were entered into EpiData version 4.6.0.6, exported to SPSS version 26 for analysis, and statistically tested at a 95% Confidence level. The mean difference was tested using an independent t-test and the relationship predictors and dependant variables were tested by using logistic regression. Results: A Total of 142 of type 2 diabetes subjects were included in the study. Mean value of alkaline phosphatase was higher in type2 with chronic kidney disease (115.27 ± 22.41 vs. 97.42 ± 29.57 P<0.001) but that of total bilirubin (0.86 ± 0.47 vs. 1.03 ± 0.48, p =0.028,) and direct bilirubin (0 .16 ± 0.083 vs. 0.21 ± 0.09 p = 0.003), were lower among T2D patients with CKD. T2D patients with chronic kidney disease were 2.2 times likelihood to have elevated alkaline phosphatase levels than diabetics without chronic kidney disease (AOR =2.2 (1.09, 4.46) p= 0.028).T2D patients without chronic kidney disease were 2.8 and 5.1 times likelihood to have elevated direct and total bilirubin than T2D with chronic kidney disease (AOR = 2.8 (1.29, 6.06) P=0.009 and AOR = 5.14(2.24, 11.56) P< 0.001) respectively. Conclusion: The mean of alkaline phosphatase was significantly higher in type 2 diabetes with chronic kidney disease than without chronic kidney disease. Whereas the mean of direct and total bilirubin was lower in type 2 patients with chronic kidney disease. Recommendation: stakeholders are recommended to consider liver biomarkers of type 2 patients with chronic kidney disease for early diagnosis, and prevention of liver disease.