Prospective study of gestational diabetes and fatty liver scores 9 to 16 years after pregnancy

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

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background: Women with gestational diabetes mellitus (GDM) may be at an increased risk of liver complications because chronic hyperglycemia is a risk factor for liver fat accumulation and potential liver dysfunction. Large prospective studies examining liver fat accumulation following a GDM pregnancy are lacking. Methods: The Diabetes & Women's Health Study (2012-2014) examined the association between GDM and subsequent fatty liver scores among 607 women with and 619 women without GDM in the Danish National Birth Cohort. Nine to 16 years postpartum, a clinical examination was performed, with measurement of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γ-glutamyl transferase, from which fatty liver scoring indices were calculated to assess liver fat score, fatty liver index, hepatic steatosis index, and liver fat percentage. Relative risks (RR) with 95% confidence intervals (CI) for elevated liver scoring indices by GDM status were assessed adjusting for major risk factors, including prepregnancy body mass index. Results: Women with prior GDM had higher adjusted ALT and AST levels than women without GDM (by 6.7% [95% CI 1.7-12.0] and 4.8% [95% CI 0.6-9.1], respectively). Women with GDM also had adjusted increased risks for elevated liver fat score (RR 2.34; 95% CI 1.68-3.27), fatty liver index (RR 1.59; 95% CI 1.27-1.99), and hepatic steatosis index (RR 1.44; 95% CI 1.21-1.71). Conclusions: Women with GDM during pregnancy were at an increased risk for fatty liver 9 to 16 years postpartum. Gestational diabetes mellitus may serve as another risk indicator for the early identification and prevention of liver fat accumulation.

Original languageEnglish (US)
Pages (from-to)895-905
Number of pages11
JournalJournal of Diabetes
Issue number11
StatePublished - Nov 1 2019

Bibliographical note

Funding Information:
information Eunice Kennedy Shriver National Institute of Child Health and Human Development, Grant/Award Numbers: HHSN275201000020C, HHSN275201500003C, HHSN275201300026I, HSN275201100002I; March of Dimes Birth Defects Foundation, Grant/Award Numbers: 6-FY-96-0240, 6-FY97-0553, 6-FY97-0521, 6-FY00-407; Innovation Fund Denmark, Grant/Award Numbers: 09-67124, 11-115923; ?Centre for Fetal Programming?, The Health Foundation, Grant/Award Number: 11/263-96; Heart Foundation, Grant/Award Number: 96-2-4-83-22450; European Union, Grant/Award Number: FP7-289346; Danish Diabetes Academy supported by the Novo Nordisk Foundation

Publisher Copyright:
© 2019 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd


  • fatty liver
  • gestational diabetes
  • hyperglycemia
  • liver fat scoring indices
  • pregnancy

PubMed: MeSH publication types

  • Journal Article


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