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J Diabetes. 2019 Apr 19. doi: 10.1111/1753-0407.12934. [Epub ahead of print]

Prospective study of gestational diabetes and fatty liver scores 9 to 16 years after pregnancy.

Author information

1
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
2
Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, Virginia.
3
Department of Nutritional Sciences, School of Health Professions, Rutgers University, Newark, New Jersey.
4
Department of Endocrinology, Diabetes and Metabolism, Rigshospitalet, Copenhagen, Denmark.
5
The Danish Diabetes Academy, Odense, Denmark.
6
Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
7
Channing Division of Network Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts.
8
Cardiovascular and Metabolic Disease Translational Medicine Unit, Early Clinical Development, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden.
9
Glotech, Rockville, Maryland.
10
Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark.
11
Institute of Clinical Medicine, Faculty of Health and Medical Services, University of Copenhagen, Copenhagen, Denmark.
12
Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
13
The Emmes Corporation, Rockville, Maryland.
14
Department of Public Health Sciences, Clemson University, Clemson, South Carolina.
15
Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota.

Abstract

BACKGROUND:

Women with gestational diabetes mellitus (GDM) may be at an increased risk of liver complications because chronic hyperglycemia is a risk factor for liver fat accumulation and potential liver dysfunction. Large prospective studies examining liver fat accumulation following a GDM pregnancy are lacking.

METHODS:

The Diabetes & Women's Health Study (2012-2014) examined the association between GDM and subsequent fatty liver scores among 607 women with and 619 women without GDM in the Danish National Birth Cohort. Nine to 16 years postpartum, a clinical examination was performed, with measurement of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γ-glutamyl transferase, from which fatty liver scoring indices were calculated to assess liver fat score, fatty liver index, hepatic steatosis index, and liver fat percentage. Relative risks (RR) with 95% confidence intervals (CI) for elevated liver scoring indices by GDM status were assessed adjusting for major risk factors, including prepregnancy body mass index.

RESULTS:

Women with prior GDM had higher adjusted ALT and AST levels than women without GDM (by 6.7% [95% CI 1.7-12.0] and 4.8% [95% CI 0.6-9.1], respectively). Women with GDM also had adjusted increased risks for elevated liver fat score (RR 2.34; 95% CI 1.68-3.27), fatty liver index (RR 1.59; 95% CI 1.27-1.99), and hepatic steatosis index (RR 1.44; 95% CI 1.21-1.71).

CONCLUSIONS:

Women with GDM during pregnancy were at an increased risk for fatty liver 9 to 16 years postpartum. Gestational diabetes mellitus may serve as another risk indicator for the early identification and prevention of liver fat accumulation.

KEYWORDS:

fatty liver; gestational diabetes; hyperglycemia; liver fat scoring indices; pregnancy

PMID:
31001915
DOI:
10.1111/1753-0407.12934

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