Hepatic alterations in patients with type 2 diabetes mellitus and arterial hypertension: a comparative clinical study

Abstract

Background: Type 2 diabetes mellitus (T2DM) and arterial hypertension (AH) frequently coexist and are strongly associated with metabolic dysfunction-related liver disease, particularly non-alcoholic fatty liver disease (NAFLD). The combined impact of these conditions on hepatic structure and function remains insufficiently characterized in clinical settings. Objective: To evaluate liver condition and degree of hepatic damage in patients with T2DM and AH compared to healthy controls, and to investigate underlying pathophysiological mechanisms. Methods: A comparative clinical study was conducted including 72 patients with T2DM and AH (36 males, 36 females) and 36 healthy controls (18 males, 18 females). All participants underwent biochemical testing (ALT, AST, GGT), abdominal ultrasound, and transient elastography. Statistical analysis included independent t-tests or Mann-Whitney U tests, correlation analysis, and multivariate regression modeling. Results: Patients with T2DM and AH demonstrated significantly elevated levels of ALT, AST (p=0.002), and GGT compared to controls. Ultrasound revealed a markedly higher prevalence of hepatic steatosis. Elastography indicated increased liver stiffness values suggestive of fibrosis. Positive correlations were observed between liver enzymes and body mass index, fasting glucose, and systolic blood pressure. Regression analysis identified insulin resistance and systolic blood pressure as independent predictors of liver stiffness. Conclusion: The coexistence of T2DM and AH significantly contributes to hepatic injury, characterized by steatosis and early fibrosis. These findings underscore the importance of early screening and integrated management strategies targeting metabolic and vascular risk factors.