Increased risk of non-alcoholic fatty liver disease in women with gestational diabetes mellitus: A population-based cohort study, systematic review and meta-analysis

Lavrentaki, Aikaterini; Thomas, Tom; Subramanian, Anuradhaa; Valsamakis, George; Thomas, G. Neil; Toulis, Konstantinos; Wang, Jingya; Daly, Barbara; Saravanan, Ponnusamy; Šumilo, Dana; Mastorakos, George; Tahrani, Abd A; Nirantharakumar, Krishnarajah

doi:10.1016/j.jdiacomp.2019.06.006

Cited by 23 publications

(23 citation statements)

References 31 publications

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“…The reported prevalence of NAFLD in women with prior GDM varies from 14 to 48% [10][11][12][13] . In a retrospective cohort study by Lavrentaki et al 14 , the unadjusted and adjusted incidence rate ratios for the development of NAFLD in women with previous GDM, compared with those without, were 3.28 and 2.70, respectively. The risk of NAFLD remained elevated, even after censoring women who developed type 2 diabetes mellitus (incidence rate ratio 2.48), suggesting an association of GDM with NAFLD independent of type 2 diabetes mellitus.…”

Section: Introductionmentioning

confidence: 93%

Prevalence of non‐alcoholic fatty liver disease and factors associated with it in Indian women with a history of gestational diabetes mellitus

Kubihal

Gupta

Shalimar

et al. 2020

J of Diabetes Invest

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Aims/Introduction: This study aims to evaluate the prevalence of and factors associated with non-alcoholic fatty liver disease (NAFLD) in Indian women with prior gestational diabetes mellitus (GDM) diagnosed using International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Materials and Methods: This cross-sectional study (2018)(2019) enrolled women with and without prior GDM. Study participants underwent detailed assessments, including relevant medical, obstetric and demographic details; 75-g oral glucose tolerance test with glucose and insulin estimation at 0, 30 and 120 min; and other relevant biochemical and anthropometric measurements. NAFLD status was defined by ultrasonography. Results: We evaluated a total of 309 women (201 and 108 with and without prior GDM, respectively) at a mean age of 31.9 -5.0 years and median of 16 months (interquartile range 9-38 months) following the index delivery. The prevalence of NAFLD was significantly higher in women with prior GDM (62.7% vs 50.0%, P = 0.038; grade 2 and 3 disease, 13.9% vs 6.5%). On logistic regression analysis (fully adjusted model), the odds of NAFLD were 2.11-fold higher in women with prior GDM (95% confidence interval 1.16-3.85, P = 0.014). Overweight/obesity, metabolic syndrome, prediabetes and homeostasis model of assessment of insulin resistance (a measure of insulin resistance) were positively associated with NAFLD, whereas the Matsuda index (a measure of insulin sensitivity) showed a negative association with NAFLD. Conclusions: The prevalence of NAFLD is high in women with prior GDM. Such women also have a high burden of cardiometabolic risk factors. Future studies should evaluate the intermediate and long-term hepatic and cardiovascular risk, and the impact of lifestyle interventions in reducing morbidity in such women.

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Section: Introductionmentioning

confidence: 93%

Prevalence of non‐alcoholic fatty liver disease and factors associated with it in Indian women with a history of gestational diabetes mellitus

Kubihal

Gupta

Shalimar

et al. 2020

J of Diabetes Invest

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“…Patients in THIN were considered for data linkage 12 months after registration with their practice and where the practice had been using electronic medical records for a minimum of 12 months and had shown acceptable mortality recording in the previous 12 months or before. 20 These three criteria ensured data quality and sufficient time for maximum and accurate documentation of all covariates. The THIN–HES data linkage was performed by NHS Digital using patient-sensitive de-anonymised data which were then anonymised and received by our team.…”

Section: Methodsmentioning

confidence: 99%

“…THIN and HES Databases, on their own and linked, have been extensively used for epidemiological studies, including longitudinal studies that examine long-term outcomes in women with exposure during pregnancy. [20][21][22] Core outcomes sets exist for studies evaluating interventions for prevention and treatment of PPH rather than epidemiological outcomes following PPH and were therefore not used.…”

Section: Study Design and Data Sourcesmentioning

confidence: 99%

Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases

et al. 2021

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ObjectiveTo investigate the long-term risk of developing hypertension and cardiovascular disease (CVD) among those women who suffered a postpartum haemorrhage (PPH) compared with those women who did not.DesignPopulation-based longitudinal open cohort study.SettingEnglish primary care (The Health Improvement Network (THIN)) and secondary care (Hospital Episode Statistics (HES)) databases.PopulationWomen exposed to PPH during the study period matched for age and date of delivery, and unexposed.MethodsWe conducted an open cohort study using linked primary care THIN and HES Databases, from 1 January 1997 to 31 January 2018. A total of 42 327 women were included: 14 109 of them exposed to PPH during the study period and 28 218 matched for age and date of delivery, and unexposed to PPH. HRs for cardiovascular outcomes among women who had and did not have PPH were estimated after controlling for covariates using multivariate Cox regression models.Outcome measuresRisk of hypertensive disease, ischaemic heart disease, heart failure, stroke or transient ischaemic attack.ResultsDuring a median follow-up of over 4 years, there was no significant difference in the risk of hypertensive disease after adjustment for covariates (adjusted HR (aHR): 1.03 (95% CI: 0.87 to 1.22); p=0.71). We also did not observe a statistically significant difference in the risk of composite CVD (ischaemic heart disease, heart failure, stroke or transient ischaemic attack) between the exposed and the unexposed cohort (aHR: 0.86 (95% CI: 0.52 to 1.43; p=0.57).ConclusionOver a median follow-up of 4 years, we did not observe an association between PPH and hypertension or CVD.

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“…The morbidity, mortality, high prevalence and economic impact of obesity have made it a worldwide public health crisis 3 . Even people with ‘metabolic healthy’ obesity are at an increased risk of complications including cardiovascular disease (CVD), non‐alcoholic fatty liver disease (NAFLD) and mortality 4–6 . While the pandemic of obesity threatens the lives of those who suffer from this chronic disease, metabolic surgery remains an underutilized tool, only serving 1%‐2% of the population who could benefit from this treatment 7 .…”

Section: Introductionmentioning

confidence: 99%

Metabolic surgery: A clinical update

Wilson

Aminian

Tahrani

2021

Diabetes Obesity Metabolism

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Metabolic and bariatric surgery has grown beyond ‘experimental’ weight‐loss surgery. As techniques have advanced over the last few decades, so has the growing body of research and evidence, proving that both weight‐loss and metabolic health improvement are induced. Metabolic surgery has become the more appropriate term for weight‐loss surgery because of the altered gastrointestinal anatomy and subsequent beneficial metabolic effects. Although the tool of metabolic surgery has been well refined, a large portion of the global population does not have adequate access to it. This clinical update aims to (a) inform healthcare providers from all disciplines about the myriad of benefits of metabolic surgery and (b) equip them with the necessary knowledge to bridge the gap between patients in need of metabolic treatment and the therapies in metabolic surgery available to them.

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Increased risk of non-alcoholic fatty liver disease in women with gestational diabetes mellitus: A population-based cohort study, systematic review and meta-analysis

Cited by 23 publications

References 31 publications

Prevalence of non‐alcoholic fatty liver disease and factors associated with it in Indian women with a history of gestational diabetes mellitus

Prevalence of non‐alcoholic fatty liver disease and factors associated with it in Indian women with a history of gestational diabetes mellitus

Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases

Metabolic surgery: A clinical update

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