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

Publication Type
Journal Article
Year of Publication
Donnelly, Sarah R; Hinkle, Stefanie N; Rawal, Shristi; Grunnet, Louise G; Chavarro, Jorge E; Vaag, Allan; Wu, Jing; Damm, Peter; Mills, James L; Li, Mengying; Bjerregaard, Anne A; Thuesen, Anne Cathrine B; Gore-Langton, Robert E; Francis, Ellen C; Ley, Sylvia H; Hu, Frank B; Tsai, Michael Y; Olsen, Sjurdur F; Zhang, Cuilin
J Diabetes
Date Published
2019 Nov
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

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.