Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10360
Title: Hepatic fat and glucose tolerance in women with recent gestational diabetes.
Authors: Mehmood, Sadia
Margolis, Myles
Ye, Chang
Maple-Brown, Louise
Hanley, Anthony J
Connelly, Philip W
Sermer, Mathew
Zinman, Bernard
Retnakaran, Ravi
Affiliation: Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada..
Department of Medical Imaging, Mount Sinai Hospital, Toronto, Ontario, Canada..
Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada..
Menzies School of Health Research, Casuarina, Australia.. Division of Medicine, Royal Darwin Hospital, Darwin, Australia..
Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada.. Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada.. Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada..
Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada.. Keenan Research Centre for Biomedical Science of St Michael's Hospital, Toronto, Ontario, Canada..
Division of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Ontario, Canada..
Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada.. Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada.. Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada..
Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada.. Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada.. Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada..
Issue Date: 2018
Citation: BMJ open diabetes research & care 2018; 6(1): e000549
Abstract: Women with a history of gestational diabetes mellitus (GDM) have an elevated risk of ultimately developing pre-diabetes and diabetes later in life. They also have an increased prevalence of fatty liver, but recent studies have reported conflicting findings on whether hepatic fat affects their risk of pre-diabetes/diabetes. Thus, we sought to evaluate the associations of liver fat with glucose homeostasis and determinants thereof in women with and without recent gestational dysglycemia. Two hundred and fifty-seven women underwent an antepartum oral glucose tolerance test (OGTT), which diagnosed 97 with GDM, 40 with gestational impaired glucose tolerance (GIGT), and 120 with normal glucose tolerance (NGT). At a mean of 4.8 years post partum, they underwent an OGTT (which revealed that 52 had progressed to pre-diabetes/diabetes) and hepatic ultrasound, on which liver fat was graded as none (n=164), mild (n=66), or moderate (n=27). Liver fat was more prevalent in women with previous GDM than in those with GIGT or NGT (p=0.009) and in women with current pre-diabetes/diabetes than in those without (p=0.0003). As the severity of liver fat increased, there was a progressive worsening of insulin sensitivity and beta-cell function, coupled with rising fasting and 2-hour glucose (all p<0.0001). On multiple linear regression analyses, moderate liver fat was independently associated with lower insulin sensitivity (p=0.0002) and higher 2-hour glucose (p=0.009). Moreover, moderate liver fat emerged as an independent predictor of pre-diabetes/diabetes (OR=3.66, 95% CI 1.1 to 12.5). The higher prevalence of liver fat in women with previous GDM is associated with their increased risk of pre-diabetes/diabetes.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10360
DOI: 10.1136/bmjdrc-2018-000549
ISSN: 2052-4897
Type: Journal Article
Subjects: fatty liver
gestational diabetes
insulin sensitivity
liver fat
pre-diabetes
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