Transaminase levels in the upper normal range are associated with oral hypoglycemic drug therapy failure in patients with type 2 diabetes
| Autor: | Viviana Vespertini, Elisabetta Mandosi, Marianna Maranghi, Raffaella Fiorentino, Susanna Morano, Concetta Irace, Marco Rossetti, Claudio Carallo, Agostino Gnasso, Sebastiano Filetti |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Endocrinology Diabetes and Metabolism Type 2 diabetes beta-cell failure Gastroenterology Transaminase liver steatosis chemistry.chemical_compound Endocrinology Pharmacotherapy Insulin resistance Internal medicine Diabetes mellitus insulin resistance Internal Medicine medicine Humans Hypoglycemic Agents Aspartate Aminotransferases Treatment Failure transaminase type 2 diabetes Glycated Hemoglobin geography geography.geographical_feature_category Chi-Square Distribution business.industry Alanine Transaminase General Medicine Middle Aged medicine.disease Islet Fatty Liver chemistry Diabetes Mellitus Type 2 Case-Control Studies Female Glycated hemoglobin Steatosis business |
| Zdroj: | Acta diabetologica. 49(3) |
| ISSN: | 1432-5233 |
| Popis: | Incident diabetes and the worsening of diabetes have recently been linked to hepatic steatosis. Aim of our study was to determine whether oral hypoglycemic agent failure is associated with higher transaminase levels (valid measure of liver steatosis). We selected 200 patients, attenders (3 consecutive annual evaluations) in our clinic, with type 2 diabetes among which 100 with oral hypoglycemic agents failure and 100 who were still responsive to oral therapy. Failure to therapy was defined as glycated hemoglobin >7.5% despite maximal-dose oral therapy. We analyzed patient histories and laboratory data. Compared with oral-therapy-responsive patients, those with failure had a significantly higher level mostly of alanine aminotransferase at the time of therapy failure and 2 years before. They were more likely to have had symptoms of hyperglycemia at the time of diabetes diagnosis. Regression analysis indicated that each 5-unit increase in transaminase levels independently increased the risk for oral hypoglycemic agents failure by 1.70. Higher liver transaminase levels, especially in patients who had symptomatic hyperglycemia at diabetes diagnosis, associate with oral hypoglycemic agent failure. The possible pathogenetic link between transaminase and declining islet function might consist of insulin resistance and increased circulating fatty acid levels, in turn causing liver steatosis and beta-cell dysfunction. |
| Databáze: | OpenAIRE |
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