Introduction: Diabetes mellitus is a global health challenge associated with numerous complications, including liver function. This study aimed to investigate the prevalence and risk factors associated with elevated liver transaminases in a of 509 diabetic patients. Methodology: A cross-sectional observational study was conducted at King Abdulaziz Medical City Riyadh, Saudi Arabia. Diabetic patients meeting inclusion criteria were enrolled and relevant data including demographics, clinical characteristics and laboratory results were extracted from electronic medical records. Statistical analyses were performed using SPSS Pc+21.0 version, employing descriptive statistics and appropriate tests for univariate analysis. Results: The majority of the 509 diabetic patients were females (58%) with a mean age of 61.5 ± 12.4. Obesity was prevalent (62.9%) and more than half had complications (55%). Comorbidities, hypertension and dyslipidemia were present in 91% of patients. Notably, 44% were diagnosed with Non-Alcoholic Fatty Liver Disease (NAFLD). Elevated liver transaminases were observed in 9.3% Aspartate Aminotransferase (AST) and 4.8% alanine transaminase (ALT) of patients. 86% of patients had suboptimal glycemic control. Unexpectedly, non-insulin hypoglycemic medications did not show a significant association with elevated liver transaminases. However, patients not on insulin therapy exhibited higher ALT levels. Statin use, prevalent in over 90% of patients did not show a significant relationship with transaminitis. Conclusion: This study reveals a complex interplay between diabetes, liver function and associated factors. The prevalence of NAFLD and suboptimal glycemic control highlights the need for comprehensive management strategies to reduce the overall liver-related morbidity and mortality.
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