ECE2018 Guided Posters Diabetes Epidemiology (11 abstracts)
Gestational Diabetes Mellitus is associated with increased risk of Non-Alcoholic Fatty Liver Disease: A population-based cohort study
Aikaterini Lavrentaki 1, , Anuradhaa Subramanian 3 , G Neil Thomas 3 , George Valsamakis 2 , Konstantinos Toulis 3, , Barbara Daly 5 , George Mastorakos 2 , Abd Tahrani 1, & Krishnarajah Nirantharakumar 3
1Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK; 2Endocrine Unit, Aretaieion University Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece; 3Institute of Applied Health Research, University of Birmingham, Birmingham, UK; 4Department of Endocrinology, 424 General Military Hospital, Thessaloniki, Greece; 5School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 6Birmingham Health Partners, Birmingham, UK.
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.
Methods and results: We conducted a retrospective cohort study after extracting data from a large primary care database (The Health Improvement Network databse) in the United Kingdom. The cohort consisted of 9640 women with GDM diagnosis and 31 296 control women, matched for age, body mass index (BMI) and time of pregnancy. All study participants were free from NAFLD diagnosis at study entry. Mean (standard deviation) age of the whole cohort was 32.62 (S.D.: 5.34) years and BMI 28.62 (S.D.: 6.10) kg/m2. There were 44 (0.46%) and 41 (0.13%) NAFLD incident diagnosis in the GDM and control population respectively over a median follow-up of 2.87 (IQR 1.16–5.81) years. Unadjusted incidence rate ratio (IRR) for NAFLD development was 3.28 (95% CI 2.14–5.02). After adjusting for age, Townsend (deprivation) quintile, smoking, BMI and Metformin usage; women with GDM remained at increased risk of developing NAFLD compared to women without GDM (IRR 2.95; 95%CI 1.91–4.55). Further adjustment for the diagnosis of polycystic ovarian syndrome, hypertension, hypothyroidism, and lipids lowering treatment did not change our findings (IRR 2.83; 95%CI 1.83–4.38).
Conclusions: Women diagnosed with GDM were at significantly increased risk of NAFLD development in their post-delivery life compared to women without GDM. Clinicians should have a low threshold to investigate women with history of GDM for the presence of NAFLD. Future studies need to examine whether lifestyle or pharmacological interventions could reduce the risk of developing NAFLD in women with history of GDM.
Volume 56
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Endocrine Abstracts
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