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Background: Diabetes mellitus (DM) is a disorder of the endocrine-metabolic system, identified by ongoing hyperglycemia and exacerbated by liver function problems. The association of the glycated albumin/hemoglobin A1c (GA/HbA1C) ratio and C-peptide (C-PEP) with liver injury in diabetes mellitus type 2 (T2DM) patients remains a topic of controversy.
Methods: 530 T2DM patients were divided into two groups: non-liver injury and liver injury group. All patients' clinical information and lab indices were gathered. In the univariate analysis, variables having a p < 0.05 were evaluated to determine the correlation between liver injury severity and variable levels, based on the patients' Child-Pugh classification. In the multivariate logistic regression analysis, GA, GA/HbA1c, and C-PEP were incorporated as separate variables to identify independent factors. The effectiveness in prediction was assessed through the receiver operating curve method. The Pearson’s correlation method was employed to examine the link between liver injury and the levels of GA/HbA1c and C-PEP in patients with T2DM.
Results: GA and GA/HbA1c were higher in the liver injury group than in the non-liver injury group, while C-PEP levels were lower. Increased levels of GA/HbA1c independently increased the risk of liver injury, showing a positive association with injury severity, while C-PEP independently acted as a protective factor, inversely related to the severity of the liver injury. Both GA/HbA1c and C-PEP had moderate predictive efficacy for liver injury in patients in the T2DM group.
Conclusions: Patients with T2DM have a high incidence of liver injury. Both GA/HbA1c and C-PEP are independent influences on liver injury in patients with T2DM, and correlate with the severity of liver injury.
DOI: 10.7754/Clin.Lab.2025.250627
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