Unit:
Κατεύθυνση Έρευνα στην Γυναικεία ΑναπαραγωγήLibrary of the School of Health Sciences
Author:
Lavrentaki Aikaterini
Supervisors info:
Γεώργιος Μαστοράκος, Καθηγητής, Ιατρική, ΕΚΠΑ
Abd A. Tahrani, Senior Lecturer in Metabolic Endocrinology and Obesity Medicine,Institute of Metabolism and Systems Research University of Birmingham, UK
Krish Nirantharakumar, Senior Lecturer in Public Health Medicine , Institute of Applied Health Research, University of Birmingham, UK
Original Title:
Increased risk of non-alcoholic fatty liver disease in women with gestational diabetes mellitus: A population-based cohort study, a systematic review and meta-analysis
Translated title:
Increased risk of non-alcoholic fatty liver disease in women with gestational diabetes mellitus: A population-based cohort study, a systematic review and meta-analysis
Summary:
Background
Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes, and increased risk of post-natal type 2 diabetes and cardiovascular disease. However, whether GDM increases the risk of developing incident Non-Alcoholic Fatty Liver Disease (NAFLD) is unclear and has not been well examined in previous studies. This is important considering the significant health burden of NAFLD and the opportunity to interfere in high risk population in order to reduce the risk of developing end-stage liver disease.
Objectives
To examine whether women with gestational diabetes mellitus (GDM) are at increased risk of developing Non-Alcoholic Fatty Liver Disease (NAFLD) compared to women without GDM.
Research Design and Methods
We conducted a population-based retrospective matched-controlled cohort study utilising The Health Improvement Network (THIN), a large primary care database representative of the United Kingdom population, between 01/01/1990 to 31/05/2016 followed by a systematic review of available literature. The study population included 9,640 women with GDM and 31,296 controls without GDM, matched for age, body mass index (BMI) and time of pregnancy. All study participants were free from NAFLD diagnosis at study entry.
Results
The median (range) follow-up duration was similar in women with and without GDM (2.95 (1.21-6.01) vs 2.85 (1.14-5.75) years respectively).Unadjusted incidence rate ratio (IRR) for NAFLD development in women with vs without GDM was 3.28 (95% CI 2.14 - 5.02), which remained significant after adjustment for a wide range of potential confounders (IRR 2.70; 95%CI 1.744 - 4.19). When women were censored when they developed type 2 diabetes during follow-up the risk of NAFLD in GDM remained high (IRR 2.46: 95% CI 1.51 - 4.00).
The meta-analysis of 3 studies (including the current study) showed increased NAFLD risk in women with vs without GDM (OR 2.60; 95% CI 1.90-3.57, I2=0%).
Conclusions
Women with GDM are at increased risk of developing NAFLD in their later life compared to women without GDM regardless of the development of type 2 diabetes. Clinicians should have a low threshold to investigate women with history of GDM for the presence of NAFLD. Further studies to identify best screening strategies are needed
Main subject category:
Health Sciences
Keywords:
Gestational diabetes mellitus, Non-alcoholic Fatty Liver Disease, Non alcoholic steatohepatitis, Gestation, Glucose intolerance
