Background Recent data have suggested that plasma aminotransferases may be of limited use in the diagnosis of non-alcoholic fatty liver disease. However, data on the use of aminotransferases to monitor change in hepatosteatotic state are lacking.
Methods 394 participants, aged 63–79 years, from the Edinburgh Type 2 Diabetes Study, a large, randomly-selected population of patients with Type 2 diabetes, were assessed on two occasions approximately 3 years apart. Liver ultrasonography was undertaken and both plasma alanine aminotransferase (ALT) and aspartateaminotransferase (AST)) were measured. Hepatic steatosis was graded as either “normal”, “mild” or “moderate/severe” according to findings on ultrasound. Change in steatosis was classified as either regression or progression by 1 or 2 categories. ANOVA (with trend) analysis was used to assess the association between change in steatosis and change in aminotransferase levels.
Results Mean follow-up was 2.7 years. 5.1% (n=20) of participants regressed two categories, 14.7% (n=58) regressed one category, 60.7% (n=239) showed no change, 12.4% (n=49) progressed one category and 7.1% (n=28) progressed two categories. There was a statistically significant linear trend for both ALT and AST (F(4,3)=4.76, p=0.03 and F(4,3)=10.70, p=0.01 respectively) indicating that as the hepatosteatosis stage changed the aminotransferase level increased or decreased proportionally.
Conclusion In a relatively large sample of patients with type 2 diabetes representative of patients with type 2 diabetes in general, we have shown that change in aminotransferase levels are proportionally associated with change in levels of hepatosteatosis. This suggests that aminotransferases may be useful in monitoring progression of steatosis.
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