Biochemical Profile Variations Among Type 2 Diabetic Patients Stratified by Hemoglobin A1c Levels in a Saudi Cohort:...

Background: The global increase in type 2 diabetes mellitus (T2DM) cases necessitates the need for early detection of metabolic changes. This study investigated variations in liver enzymes, renal markers, electrolytes, and lipid profiles among T2DM patients stratified by hemoglobin A1c (HbA1c) categories to support early identification and better management of diabetes-related complications. Methods: A retrospective observational study at King Khalid University Hospital (KKUH), Riyadh, included 621 adult patients diagnosed with T2DM categorized into four HbA1c groups: normal (<5.7%), prediabetes (5.7-6.4%), controlled diabetes (6.5-7.9%), and uncontrolled diabetes (≥8.0%). Biochemical parameters included the liver profile: alkaline phosphatase (ALP) and bilirubin, renal profile: creatinine, blood urea nitrogen (BUN), glucose, sodium, and chloride, and lipid profile: cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides. Regression models identified predictors of ALP, cholesterol, and LDL. Results: ALP was higher in uncontrolled diabetes (89.0 U/L, Q1-Q3: 106.3-72.0) than in the prediabetes group (75.0 U/L, Q1-Q3: 96.8-62.3). Sodium and chloride were lower in uncontrolled diabetes (Na: 138.3 mmol/L, Q1-Q3: 140.3-136.4; Cl: 101.1 mmol/L, Q1-Q3: 102.9-99.4) compared to the normal group (Na: 139.5 mmol/L, Q1-Q3: 142.4-136.9; Cl: 103.5 mmol/L, Q1-Q3: 106.1-101.7). LDL was lower in uncontrolled diabetes (2.1 mmol/L, Q1-Q3: 2.8-1.7) than in the normal group (2.8 mmol/L, Q1-Q3: 3.7-2.2), while triglycerides were higher in patients with uncontrolled diabetes compared to the normal group (1.45 mmol/L, Q1-Q3: 2.02-1.11 vs. 1.26 mmol/L, Q1-Q3: 1.44-0.94). Regression models showed low explanatory power (R² = 2.1-7.3%), with weight, age, and sex as significant predictors of select biochemical markers. Conclusions: The study observed biochemical variations across HbA1c categories in T2DM patients, likely reflecting insulin resistance. Monitoring these markers in conjunction with HbA1c can enhance early detection and improve the management of complications.