University of Sydney, Sydney, NSW, Australia; Dept of Diabetes & Endocrinology, Westmead Hospital, Sydney, NSW, Australia.
University of Sydney, Sydney, NSW, Australia; Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, NSW, Australia.
Diabetes Res Clin Pract. 2021 Apr;174:108757. doi: 10.1016/j.diabres.2021.108757. Epub 2021 Mar 17.
Metabolic associated fatty liver disease (MAFLD) is a leading cause of chronic liver disease and has been increasingly associated with gestational diabetes (GDM). This study aimed to assess the prevalence of MAFLD in women with GDM in the antenatal period.
108 pregnant women with GDM diagnosed on a 75-gram oral glucose tolerance test were enrolled from a multiethnic cohort attending a large obstetrics clinic in Sydney, Australia and had a single FibroScan® assessment after 24 weeks gestation to assess for hepatic steatosis and fibrosis. A control attenuated parameter (CAP) cut-off score of ≥ 233.5 dB/m was chosen to signify presence of hepatic steatosis which indicates MAFLD. Obstetric, anthropometric and metabolic measures were analysed.
29 (26.9%) women had evidence of FibroScan®-detected MAFLD, whilst none had evidence of hepatic fibrosis. Increased maternal BMI (aOR 1.12, 95% CI: 1.04-1.20) was associated with the finding of MAFLD in this cohort.
We found a significant antenatal prevalence of FibroScan®-detected MAFLD in this cohort of multiethnic women with GDM. FibroScan® is a safe and rapid assessment tool which may have a role in screening for MAFLD in pregnancy in appropriate at-risk women.
代谢相关脂肪性肝病（MAFLD）是慢性肝病的主要病因，并且与妊娠糖尿病（GDM）的关系日益密切。本研究旨在评估妊娠期糖尿病女性在产前期间 MAFLD 的患病率。
从澳大利亚悉尼一家大型产科诊所参加多民族队列的 108 名经 75 克口服葡萄糖耐量试验诊断为 GDM 的孕妇中招募了本研究对象，这些孕妇在妊娠 24 周后接受了单次 FibroScan®评估，以评估肝脂肪变性和纤维化。选择衰减参数（CAP）截断值≥233.5dB/m 来表示肝脂肪变性，这表明存在 MAFLD。分析了产科、人体测量和代谢指标。
29 名（26.9%）女性有 FibroScan®检测到的 MAFLD 证据，而无一例有肝纤维化证据。在该队列中，母亲 BMI 增加（aOR 1.12，95%CI：1.04-1.20）与 MAFLD 的发现相关。
我们在该 GDM 多民族女性队列中发现了 FibroScan®检测到的 MAFLD 的显著产前患病率。FibroScan®是一种安全且快速的评估工具，在适当的高危女性中可能在妊娠期 MAFLD 的筛查中发挥作用。
