Metabolic Spillover of Dysglycemia: Multiorgan Biochemical Signatures Across Kidney, Liver, and Lipid Pathways

Abstract

Background: Glycated hemoglobin (HbA1c) is a widely used indicator of chronic glycemic exposure and is central to diabetes diagnosis, monitoring, and prevention of microvascular and macrovascular complications. Because diabetes affects multiple organ systems, interpretation of HbA1c may be strengthened when renal, hepatic, and lipid biomarkers are assessed concurrently.

Objective: This study evaluated the age- and sex-stratified distribution of HbA1c-tested diabetic patients between 2019 and 2022 and explored the relationship between poor glycemic control and selected renal, hepatic, and lipid biomarkers in the 2022 dataset.

Methods: A retrospective cross-sectional laboratory analysis was performed using anonymized patient records from 2019-2022. Patients were stratified into three age categories (<30, 30-60, and >60 years) and by sex. For 2022, additional biomarkers, including micro-creatinine ratio, urea, creatinine/Glomerular Filtration Rate (GFR) ratio, uric acid, bilirubin, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase, albumin, total protein, cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, and very-low density lipoprotein, were summarized according to age and sex. Descriptive analysis was used to identify year-wise demographic patterns and biomarker abnormalities associated with elevated HbA1c.

Results: The dataset showed a persistent burden of abnormal HbA1c across adult age groups. The 30-60-year age band contributed the largest number of HbA1c records in 2020 and 2021, whereas the >60-year group was prominent in 2022. In the 2022 biomarker subset, abnormal renal markers, dyslipidemia, and liver enzyme variations were observed among patients with elevated HbA1c. Younger males showed a high proportion of abnormal cholesterol and triglyceride results, while younger females showed comparatively higher abnormal urea, uric acid, and alanine aminotransferase proportions. These findings support the clinical value of paired HbA1c-biomarker monitoring.

Conclusion: The study emphasizes that HbA1c should not be interpreted in isolation in patients with diabetes. Combined assessment with renal, hepatic, and lipid biomarkers may improve early recognition of diabetic complications and guide personalized care. Larger patient-level analyses with standardized denominators are recommended to confirm the observed patterns.

Keywords: Diabetes Mellitus; HbA1c; Glycemic Control; Renal Biomarkers; Lipid Profile; Liver Function Tests

Citation

Rehan Uppal M, Uppal R, Saeed U, Saad Uppal M, Zahid Piracha Z. Metabolic Spillover of Dysglycemia: Multiorgan Biochemical Signatures Across Kidney, Liver, and Lipid Pathways. WebLog J Biochem. wjbc.2026.h2901. https://doi.org/10.5281/zenodo.22495252