Signe Foghsgaard1,2, Camilla Andreasen1, Louise Vedtofte1, Emilie S Andersen1, Emilie Bahne1, Charlotte Strandberg3, Thora Buhl4, Jens J Holst5, Jens A Svare6, Tine D Clausen7, Elisabeth R Mathiesen8, Peter Damm9, Lise L Gluud1, Filip K Knop1,5, Tina Vilsbøll10. 1. Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. 2. Danish Diabetes Academy, Odense University Hospital, Odense, Denmark. 3. Department of Radiology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. 4. Department of Nuclear Medicine, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. 5. Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Hellerup, Denmark. 6. Department of Obstetrics and Gynecology, Herlev Hospital, University of Copenhagen, Herlev, Denmark. 7. Department of Gynecology and Obstetrics, Nordsjællands Hospital, University of Copenhagen, Hillerød, Denmark. 8. Center for Pregnant Women with Diabetes, Department of Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 9. Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 10. Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark t.vilsboll@dadlnet.dk.
Abstract
OBJECTIVE: Type 2 diabetes increases the risk of nonalcoholic fatty liver disease (NAFLD), which is a potentially reversible condition but is also associated with progressive fibrosis and cirrhosis. Women with prior gestational diabetes mellitus (pGDM) have a higher risk for NAFLD. RESEARCH DESIGN AND METHODS: One hundred women without diabetes who had pGDM (median [interquartile range]: age 38.6 [6.4] years; BMI 31.0 [6.2] kg/m2) and 11 healthy control subjects without NAFLD (age 37.9 [7.8] years; BMI 28.1 [0.8] kg/m2) underwent a 75-g oral glucose tolerance test (OGTT), DXA whole-body scan, and ultrasonic evaluation of hepatic steatosis. RESULTS: Twenty-four (24%) women with pGDM had NAFLD on the basis of the ultrasound scan. None had cirrhosis. Women with NAFLD had a higher BMI (P = 0.0002) and waist circumference (P = 0.0003), increased insulin resistance (P = 0.0004), and delayed suppression of glucagon after the OGTT (P < 0.0001), but NAFLD was not associated with the degree of glucose intolerance (P = 0.2196). Visceral fat mass differed among the three groups, with the NAFLD group having the highest amount of fat and the control subjects the lowest (P = 0.0003). By logistic regression analysis, insulin resistance (P = 0.0057) and waist circumference (P = 0.0109) were independently associated with NAFLD. CONCLUSIONS: NAFLD was prevalent in this cohort of relatively young and nonseverely obese women with pGDM who are considered healthy apart from their increased risk for diabetes. Insulin resistance and a larger waist circumference were independently associated with the presence of NAFLD, whereas glucose intolerance was not.
OBJECTIVE: Type 2 diabetes increases the risk of nonalcoholic fatty liver disease (NAFLD), which is a potentially reversible condition but is also associated with progressive fibrosis and cirrhosis. Women with prior gestational diabetes mellitus (pGDM) have a higher risk for NAFLD. RESEARCH DESIGN AND METHODS: One hundred women without diabetes who had pGDM (median [interquartile range]: age 38.6 [6.4] years; BMI 31.0 [6.2] kg/m2) and 11 healthy control subjects without NAFLD (age 37.9 [7.8] years; BMI 28.1 [0.8] kg/m2) underwent a 75-g oral glucose tolerance test (OGTT), DXA whole-body scan, and ultrasonic evaluation of hepatic steatosis. RESULTS: Twenty-four (24%) women with pGDM had NAFLD on the basis of the ultrasound scan. None had cirrhosis. Women with NAFLD had a higher BMI (P = 0.0002) and waist circumference (P = 0.0003), increased insulin resistance (P = 0.0004), and delayed suppression of glucagon after the OGTT (P < 0.0001), but NAFLD was not associated with the degree of glucose intolerance (P = 0.2196). Visceral fat mass differed among the three groups, with the NAFLD group having the highest amount of fat and the control subjects the lowest (P = 0.0003). By logistic regression analysis, insulin resistance (P = 0.0057) and waist circumference (P = 0.0109) were independently associated with NAFLD. CONCLUSIONS: NAFLD was prevalent in this cohort of relatively young and nonseverely obesewomen with pGDM who are considered healthy apart from their increased risk for diabetes. Insulin resistance and a larger waist circumference were independently associated with the presence of NAFLD, whereas glucose intolerance was not.
Authors: Seung Mi Lee; Soo Heon Kwak; Ja Nam Koo; Ig Hwan Oh; Jeong Eun Kwon; Byoung Jae Kim; Sun Min Kim; Sang Youn Kim; Gyoung Min Kim; Sae Kyung Joo; Bo Kyung Koo; Sue Shin; Chanthalakeo Vixay; Errol R Norwitz; Chan-Wook Park; Jong Kwan Jun; Won Kim; Joong Shin Park Journal: Diabetologia Date: 2018-11-23 Impact factor: 10.122
Authors: Sarah R Donnelly; Stefanie N Hinkle; Shristi Rawal; Louise G Grunnet; Jorge E Chavarro; Allan Vaag; Jing Wu; Peter Damm; James L Mills; Mengying Li; Anne A Bjerregaard; Anne Cathrine B Thuesen; Robert E Gore-Langton; Ellen C Francis; Sylvia H Ley; Frank B Hu; Michael Y Tsai; Sjurdur F Olsen; Cuilin Zhang Journal: J Diabetes Date: 2019-06-12 Impact factor: 4.006
Authors: Sadia Mehmood; Myles Margolis; Chang Ye; Louise Maple-Brown; Anthony J Hanley; Philip W Connelly; Mathew Sermer; Bernard Zinman; Ravi Retnakaran Journal: BMJ Open Diabetes Res Care Date: 2018-09-08