Prospective Study of Gestational Diabetes and Fatty Liver Scores 9 to 16 Years After Pregnancy
11/2019
Journal Article
Authors:
Donnelly, S.R.;
Hinkle, S.N.;
Rawal, S.;
Grunnet, L.G.;
Chavarro, J.E.;
Vaag, A.;
Wu, J.;
Damm, P.;
Mills, J.L.;
Li, M.;
Bjerregaard, A.A.;
Thuesen, A.Cathrine B.;
Gore-Langton, R.E.;
Francis, E.C.;
Ley, S.H.;
Hu, F.B.;
Tsai, M.Y.;
Olsen, S.F.;
Zhang, C.
Secondary:
J Diabetes
Volume:
11
Pagination:
895-905
Issue:
11
PMID:
31001915
Keywords:
Adult; Alanine Transaminase; Aspartate Aminotransferases; Biomarkers; body mass index; Denmark; Diabetes, Gestational; Fatty Liver; Female; Follow-Up Studies; Humans; Longitudinal Studies; Pregnancy; prognosis; Prospective Studies; Risk Factors
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.
