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Gestational diabetes risk marker for NAFLD

Gestational diabetes mellitus was linked to nonalcoholic fatty liver disease in middle-aged women, according to the results of a longitudinal cohort study.

“This is the largest study examining the relationship between [gestational diabetes mellitus] and NAFLD and utilized a unique and well-characterized cohort of black and white women from multiple regions of the United States with 25 years of anthropometric and metabolic profiling. As an early risk marker for NAFLD, women with [gestational diabetes mellitus] may be viewed as a target group for lifestyle interventions aimed at preventing the sequelae of NAFLD,” Norah A. Terrault, MD, MPH, of the division of gastroenterology, University of California San Francisco, and colleagues wrote.

Norah A. Terrault

The researchers evaluated data of 1,115 women enrolled in the multicenter Coronary Artery Risk Development in Young Adults study, a multicenter community-based longitudinal cohort study of cardiovascular disease in young black and white adults, who had given birth at least once and did not have any evidence of diabetes prior to pregnancy. Fifty-seven percent of the cohort was black and median age at baseline was 25 years. All women underwent CT quantification of hepatic steatosis 25 years following cohort entry (2010-2011), according to the research. Eleven percent reported a history of gestational diabetes mellitus and 7% met the CT definition for NAFLD at year 25.

“We sought to evaluate the impact of previous [gestational diabetes mellitus] on the prevalence of NAFLD in middle age while controlling for known metabolic risk factors in a biracial cohort … we hypothesized that a history of [gestational diabetes mellitus] would be directly associated with NAFLD despite adjustment for metabolic risk factors,” the researchers wrote.

The crude risk for NAFLD at the 25-year visit was 2.56-fold greater in women with gestational diabetes mellitus (14%) compared with women without it (5.8%; OR = 2.56; 95% CI, 1.44–4.55).

After adjusting for variables in the final multivariable logistic regression analysis, a history of gestational diabetes mellitus remained associated with NAFLD (OR = 2.29; 95% CI, 1.23–4.27).

The addition of incident diabetes mellitus into the final fully adjusted multivariate model reduced the association between gestational diabetes mellitus and NAFLD (OR = 1.48; 95% CI, 0.73–3.02), and was no longer significant.

The researchers concluded: “Our study shows that a history of [gestational diabetes mellitus] may help to identify young women at risk and allow targeted strategies to prevent morbidity and mortality related to NAFLD.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.