Increased prevalence of non-alcoholic fatty liver disease in European women with a history of gestational diabetes
Increased prevalence of non-alcoholic fatty liver disease in European women with a history of gestational diabetes
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DOI：
10.1007/s00125-010-2009-0
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发表时间：
2011-03-01
期刊：
影响因子：
8.2
通讯作者：
Johnston, D. G.
中科院分区：
文献类型：
--
作者：
Forbes, S.;Taylor-Robinson, S. D.;Johnston, D. G.
非酒精性脂肪肝（NAFLD）在2型糖尿病中很常见，但目前尚不清楚NAFLD是否在有2型糖尿病风险的欧洲女性中普遍存在。我们研究了欧洲有妊娠期糖尿病（GDM）史的2型糖尿病高危妇女中NAFLD的患病率和危险因素，共从产前数据库中回顾性招募了110名有GDM史的妇女和113名无GDM史的妇女，这些妇女均具有非糖尿病性葡萄糖耐量。参与者接受肝脏超声扫描检查，人体测量和肝功能检查的血液采样，并确定空腹血脂，NEFA和胰岛素和葡萄糖浓度水平，以获得胰岛素敏感性和胰岛素分泌指数（HOMA%S和HOMA%B，有GDM病史的妇女与无GDM病史的妇女相比，BMI无显著差异（分别为28.9 ± 0.6和27.9 ± 0.6 kg/m2; p = 0.12）。有GDM病史的妇女在75 g OGTT后空腹和2 h血糖浓度较高（[平均值+/- SEM]空腹血糖5.3 +/- 0.1 vs. 5.1 +/- 0.1 mmol/l，p = 0.02; 2小时血糖6.8 +/- 0.2 vs. 5.8 +/- 0.3 mmol/l，p = 0.02），血脂异常（LDL-胆固醇3.3 +/- 0.1 vs. 2.8 +/- 0.1 mmol/l; HDL-胆固醇[中位数{四分位数间距}] 1.3 [1.2-1.6] vs. 1.8 [1.5-1.9] mmol/l;三酰甘油1.3 [0.9-1.6]对1.0 [0.7-1.7] mmol/l，所有p a千分之一货币单位（欧元千分之0.03），胰岛素分泌增加，胰岛素敏感性降低。与既往无GDM的女性相比，既往有GDM的女性中NAFLD患病率更高：38%（95% CI 28-47%）vs. 17%（95% CI 10-24%），p = 0.001。在多元逻辑回归分析中，较低的胰岛素敏感性和升高的血清丙氨酸转氨酶浓度与NAFLD相关。胰岛素敏感性受损和肝脏转氨酶活性增加与这些女性的NAFLD密切相关。
Non-alcoholic fatty liver disease (NAFLD) is common in type 2 diabetes but it is unknown whether NAFLD is prevalent in European women at risk of type 2 diabetes. We studied the prevalence of, and risk factors for, NAFLD in European women with previous gestational diabetes (GDM) at high risk of type 2 diabetes.A total of 110 women with previous GDM and 113 without previous GDM, with non-diabetic glucose tolerance were recruited retrospectively from antenatal databases. Participants underwent liver ultrasound scan examination, anthropometry and blood sampling for liver function tests and to determine levels of fasting lipids, NEFA and insulin and glucose concentrations in order to derive insulin sensitivity and insulin secretion indices (HOMA%S and HOMA%B, respectively).There was no significant difference in BMI in women with previous GDM compared with those without previous GDM (28.9 +/- 0.6 vs. 27.9 +/- 0.6 kg/m(2), respectively; p = 0.12). Women with previous GDM had higher fasting and 2 h glucose concentrations following a 75 g OGTT ([mean +/- SEM] fasting glucose 5.3 +/- 0.1 vs. 5.1 +/- 0.1 mmol/l, p = 0.02; 2 h glucose 6.8 +/- 0.2 vs. 5.8 +/- 0.3 mmol/l, p = 0.02), dyslipidaemia (LDL-cholesterol 3.3 +/- 0.1 vs. 2.8 +/- 0.1 mmol/l; HDL-cholesterol [median {interquartile range}] 1.3 [1.2-1.6] vs. 1.8 [1.5-1.9] mmol/l; triacylglycerol 1.3 [0.9-1.6] vs. 1.0 [0.7-1.7] mmol/l, all p a parts per thousand currency signaEuro parts per thousand 0.03), higher insulin secretion and lower insulin sensitivity. NAFLD prevalence was greater in women with previous GDM compared with those without previous GDM: 38% (95% CI 28-47%) vs. 17% (95% CI 10-24%), p = 0.001. In multiple logistic regression analysis, lower insulin sensitivity and raised serum alanine transaminase concentrations were associated with NAFLD.NAFLD is prevalent in European women with previous GDM. Impaired insulin sensitivity and increased liver transaminase activity are closely associated with NAFLD in these women.