期刊
AMERICAN JOURNAL OF GASTROENTEROLOGY
卷 111, 期 5, 页码 658-664出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1038/ajg.2016.57
关键词
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资金
- NHLBI
- National Heart, Lung, and Blood Institute
- University of Alabama at Birmingham [HHSN268201300025C, HHSN268201300026C]
- Northwestern University [HHSN268201300027C]
- University of Minnesota [HHSN268201300028C]
- Kaiser Foundation Research Institute [HHSN268201300029C]
- Johns Hopkins University School of Medicine [HHSN268200900041C]
- Intramural Research Program of the National Institute on Aging
- National Institute of Diabetes, Digestive and Kidney Diseases [K01 DK059944, R01 DK090047, T32 5T32DK060414-13]
- National Heart, Lung, and Blood Institute [R01 HL098445]
- American Association for the Study of Liver Diseases Foundation
- National Institutes of Health's National Center for Advancing Translational Sciences [KL2TR001]
- NIH [T32 DK060414]
- K01 grant
- R01 grant
OBJECTIVES: Insulin resistance is central to the development of non-alcoholic fatty liver disease (NAFLD), and gestational diabetes mellitus (GDM) is an early marker of insulin resistance. We hypothesized that a history of GDM would identify women at higher risk of NAFLD in middle age. METHODS: Women from the multicenter Coronary Artery Risk Development in Young Adults (CARDIA) cohort study who delivered >= 1 birth, were free of diabetes prior to pregnancy(ies), and underwent CT quantification of hepatic steatosis 25 years following cohort entry (Y25: 2010-2011) were included (n = 1,115). History of GDM by self-report, validated in a subsample by review of antenatal glucose testing, and metabolic risk factors were assessed prospectively. NAFLD was defined by liver attenuation (LA)<= 40 Hounsfield Units on CT scan after exclusion of other causes of hepatic steatosis. RESULTS: Of 1,115 women meeting selection criteria (57% black, 43% white, median age 25 years at baseline), 124 (11%) reported a history of GDM and 75 (7%) met the CT definition for NAFLD at year 25. The crude risk of NAFLD at the 25-year visit was significantly higher in women with GDM compared to those without (14 vs. 5.8%, OR: 2.56, 95% CI: 1.44-4.55, P < 0.01). History of GDM remained associated with NAFLD (OR: 2.29, 95% CI: 1.23-4.27, P = 0.01) after adjustment for covariates in multivariable logistic regression. Addition of incident diabetes mellitus (DM) into the final model attenuated the association between GDM and NAFLD (OR: 1.48, 95% CI: 0.73-3.02, P = 0.28). Conclusion: GDM is a risk marker for NAFLD and represents an opportunity to identify women at risk for NAFLD at a young age and may be mediated by the development of incident DM.
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