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Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is a common comorbidity in patients with type 2 diabetes mellitus (T2DM) and is often associated with elevated alanine aminotransferase (ALT) levels, reflecting hepatic inflammation. Poor glycemic control has been linked to worsening liver pathology, but the relationship between glycemic control and liver enzyme elevation in NAFLD remains to be clarified. Objective: To assess the differences in elevated ALT levels between well-controlled and poorly controlled type 2 diabetic patients with NAFLD. Study Design: Descriptive cross-sectional study. Setting: Department of Medicine at Khyber Teaching Hospital in Peshawar. Duration of Study: The study was conducted over six months from 11 February 2024 to 11 August 2024. Methods: 98 patients aged 30 to 70 years with confirmed T2DM and NAFLD were enrolled and divided into groups based on glycemic control: Group A (well-controlled diabetes) and Group B (poorly controlled diabetes). ALT levels were measured, with values >40 IU/L considered elevated. Data were analyzed using SPSS version 24. Independent t-tests were applied to compare mean ALT levels between the two groups, with a p-value ≤ 0.05 considered statistically significant. Results: The mean age in Group A was 48.94 ± 12.70 years, while Group B was 47.61 ± 12.19 years. Group A had significantly lower mean ALT levels (17.78 ± 11.09 IU/L) compared to Group B (27.43 ± 13.57 IU/L), with the difference being statistically significant (p = 0.0001). Conclusion: Well-controlled type 2 diabetic patients with NAFLD exhibited significantly lower ALT levels compared to those with poorly controlled diabetes. These findings underscore the importance of maintaining optimal glycemic control to mitigate hepatic injury in diabetic patients with NAFLD.