Nonalcoholic Fatty Liver Disease Is Prevalent in Women With Prior Gestational Diabetes Mellitus and Independently Associated With Insulin Resistance and Waist Circumference.
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.



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.



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.



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.
Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.|Danish Diabetes Academy, Odense University Hospital, Odense, Denmark.
Signe
S
Foghsgaard
Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Camilla
C
Andreasen
Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Louise
L
Vedtofte
Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Emilie S
ES
Andersen
Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Emilie
E
Bahne
Department of Radiology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Charlotte
C
Strandberg
Department of Nuclear Medicine, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Thora
T
Buhl
Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Hellerup, Denmark.
Jens J
JJ
Holst
Department of Obstetrics and Gynecology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
Jens A
JA
Svare
Department of Gynecology and Obstetrics, Nordsjællands Hospital, University of Copenhagen, Hillerød, Denmark.
Tine D
TD
Clausen
Center for Pregnant Women with Diabetes, Department of Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Elisabeth R
ER
Mathiesen
Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Peter
P
Damm
Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Lise L
LL
Gluud
Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.|Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Hellerup, Denmark.
Filip K
FK
Knop
Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark t.vilsboll@dadlnet.dk.
Tina
T
Vilsbøll
D000328:Adult; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005260:Female; D005934:Glucagon / Q000032:analysis; D018149:Glucose Intolerance / Q000150:complications; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat; D065626:Non-alcoholic Fatty Liver Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D049590:Postpartum Period; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D055105:Waist Circumference
D005934:Glucagon