Poster Presentation Australasian Diabetes in Pregnancy Society Annual Scientific Meeting 2019

The prevalence of non-alcoholic fatty liver detected by FibroScan® in pregnant women at risk of developing gestational diabetes in a multiethnic population in Western Sydney (#46)

Difei Deng 1 2 , Dharmintra Pasupathy 3 , Jacob George 4 , N Wah N Cheung 2
  1. University of Sydney, Sydney, NSW, Australia
  2. Endocrinology, Westmead Hospital, Sydney, NSW, Australia
  3. Maternal Fetal Medicine and Perinatal Epidemiology , St Thomas' Hospital, London, United Kingdom
  4. Gastroenterology/Hepatology, Westmead Hospital, Sydney, NSW, Australia

Introduction:

Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in the developed world and is closely associated with Type 2 diabetes (T2DM). Recent studies suggest women with NAFLD detected in early pregnancy have higher risk of developing gestational diabetes (GDM) as well as T2DM in later life [1, 2].

 

Aims:

To identify the prevalence of NAFLD in a multiethnic population of pregnant women at risk of developing GDM and follow their subsequent incidence of GDM

 

Methods:

As part of a longitudinal study, pregnant women identified as high risk for developing GDM as per ADIPS guidelines attending antenatal services at Westmead Hospital were recruited at prior to 24 weeks gestation for a FibroScan® to assess for liver steatosis and fibrosis. We excluded women with Type 1 or 2 diabetes, significant alcohol consumption and pre-existing liver disease.

 

Results:

29 pregnant women (target = 50) at risk of GDM have been recruited to date and had their first FibroScan®. The mean gestation at scan was 19±2.9 weeks, maternal age 33.2±3.8 years and BMI 24.7±5.5 kg/m2. Four women (14%) had elevated liver steatosis levels (steatosis grade ≥S1) by FibroScan® assessment. All women had normal liver stiffness measurements. Early analysis of risk factors in this cohort suggested that BMI may correlate with fatty liver with a higher mean BMI seen in women with increased liver steatosis (30.6±9.0 kg/m2) compared to those without steatosis (mean difference 6.9 kg/m2, 95% confidence interval 1.3–12.5 kg/m2, p=0.018).

 

Conclusions:

There was a significant prevalence of FibroScan®-detected NAFLD in a multiethnic, relatively young population of women in early pregnancy at risk of GDM, particularly in women with higher BMIs. We will continue to explore how NAFLD correlates with development of GDM in these women and if there are any associated interval liver changes on subsequent FibroScan® assessment as the study progresses. This may potentially guide earlier screening for both GDM and fatty liver in appropriate at-risk women.

  1. De Souza, L.R., et al., Non-Alcoholic Fatty Liver Disease in Early Pregnancy Predicts Dysglycemia in Mid-Pregnancy: Prospective Study. Am J Gastroenterol, 2016. 111(5): p. 665-70.
  2. Mehmood, S., et al., Hepatic fat and glucose tolerance in women with recent gestational diabetes. BMJ Open Diabetes Res Care, 2018. 6(1): p. e000549.