Clinical Original Article
Effect of nonalcoholic fatty liver disease on glucose and lipid metabolism during pregnancy
Qian Yiling, Zhang Yu, Li Xuesong, Song Yuping, Fan Xiaofang, Yang Jialin
Published 2021-12-25
Cite as Chin J Endocrinol Metab, 2021, 37(12): 1056-1060. DOI: 10.3760/cma.j.cn311282-20210728-00479
Abstract
ObjectiveTo investigate the effect of nonalcoholic fatty liver disease (NAFLD) on glucose and lipid metabolism during pregnancy.
MethodsA retrospective analysis was performed in women who gave birth in Minhang Hospital Affiliated to Fudan University from January 2013 to June 2020. The data on demographic, clinical examination, and delivery were obtained via electronic medical record abstraction. According to the ultrasound imaging, all pregnant women were divided into NAFLD group and control group. The difference of glucose and lipid metabolism indexes, incidence of gestational diabetes mellitus, and gestational hypertension between two groups were compared. Logistic regression model was used to examine potential associations between NAFLD and metabolic related adverse pregnancy outcomes.
ResultsA total of 14 708 pregnant women with a mean age of (29.1±4.7) years and a mean body mass index of (21.0±2.8) kg/m2 were included in our study. Of those eligible women, 554 (3.8%) were confirmed by ultrasound as NAFLD. Pregnant women with NAFLD presented higher circulating levels of fasting glucose [(4.2±0.5)mmol/L vs (4.1±0.5)mmol/L, P<0.01], 1 h plasma glucose [(7.4±1.7)mmol/Lvs (6.6±1.6)mmol/L, P<0.01] and 2 h plasma glucose [(6.2±1.4)mmol/Lvs (5.7±1.3)mmol/L, P<0.01] after glucose loading, HbA1C [(5.2±0.4)% vs (5.1±0.5)%, P<0.01], triglyceride [(2.1±1.1)mmol/Lvs (1.6±0.7)mmol/L, P<0.01], total cholesterol [(4.8±0.8)mmol/Lvs (4.7±0.9)mmol/L, P<0.01], low density lipoprotein-cholesterol [(2.6±0.7)mmol/Lvs (2.5±0.7)mmol/L, P<0.01], uric acid [(224.1±51.8)μmol/Lvs (203.0±45.9)μmol/L,P<0.01] level. After adjusting for potential confounders, NAFLD significantly increased the risk of gestational diabetes mellitus (OR=1.722, 95%CI 1.079-2.747, P=0.023) and gestational hypertension (OR=3.845, 95%CI 2.247-6.582, P<0.001).
ConclusionsCompared to non NAFLD, women with a diagnosis of NAFLD had more significant glucose and lipid metablic aberrations during pregnancy and increased incidence of gestational diabetes and gestational hypertension. Pregnant women with NAFLD should be closely monitored on glucose and lipid metabolism and blood pressure to prevent gestational diabetes mellitus and hypertension.
Key words:
Nonalcoholic fatty liver disease; Glucose and lipid metabolism; Gestational diabetes mellitus; Gestational hypertension
Contributor Information
Qian Yiling
Department of Endocrinology, Minhang Hospital Affiliated to Fudan University, Shanghai 201199, China
Zhang Yu
Department of Endocrinology, Minhang Hospital Affiliated to Fudan University, Shanghai 201199, China
Li Xuesong
Department of Endocrinology, Minhang Hospital Affiliated to Fudan University, Shanghai 201199, China
Song Yuping
Department of Endocrinology, Minhang Hospital Affiliated to Fudan University, Shanghai 201199, China
Fan Xiaofang
Department of Endocrinology, Minhang Hospital Affiliated to Fudan University, Shanghai 201199, China
Yang Jialin
Department of Endocrinology, Minhang Hospital Affiliated to Fudan University, Shanghai 201199, China
