Nonalcoholic fatty liver disease (NAFLD), characterized by accumulation of triglycerides in the liver in the absence of excessive alcohol consumption, is the most common liver disorder in the Western Hemisphere. NAFLD is associated with increased risk of cardiovascular disease and may progress to fibrosis, cirrhosis, and end-stage liver failure. A new study found that women with prior gestational diabetes have a higher risk for NAFLD.
Researchers from Center for Diabetes Research at University of Copenhagen (Hellerup, Denmark) recruited 100 women without type 2 diabetes (T2D) but had prior gestational diabetes and evaluated the presence of NAFLD in this cohort. They also recruited 11 healthy women without T2D and without prior gestational diabetes as the control group. All study participants underwent the oral glucose tolerance test (OGTT) and had their blood samples analyzed.
The researchers found that 24% of the women with prior gestational diabetes had developed NAFLD, and these women had a higher BMI, greater waist circumference, increased insulin resistance, and delayed suppression of glucagon after the OGTT. Compared with the women in the control group, women with NAFLD had the highest amount of visceral fat mass. The researchers also found that insulin resistance and waist circumference were independently associated with the presence of NAFLD.
The study results were published in the journal Diabetes Care (Jan 2017).
Why is this clinically important?
- Women without T2D but had prior gestational diabetes have a higher chance to progress to overt T2D and NAFLD
- For clinicians, these women represent a valuable target group for early intervention to prevent disease progression
- The early metabolic changes among healthy women with prior gestational diabetes can be addressed through nutrition and lifestyle interventions
- To minimize the risk of gestational diabetes (and subsequent risk of NAFLD and T2D), women planning to become pregnant should seek nutritional advice regarding glucose control
 Foghsgaard, S., et al., Nonalcoholic Fatty Liver Disease Is Prevalent in Women With Prior Gestational Diabetes Mellitus and Independently Associated With Insulin Resistance and Waist Circumference. Diabetes Care, 2017. 40(1): p. 109-116.