Division of Hepatology, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden; Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
Division of Gastroenterology and Hepatology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Clinical and Translational Epidemiology Unit (CTEU), Massachusetts General Hospital, Boston, MA, USA.
J Hepatol. 2021 Nov;75(5):1042-1048. doi: 10.1016/j.jhep.2021.06.045. Epub 2021 Jul 18.
BACKGROUND & AIMS: Maternal obesity has been linked to the development of cardiovascular disease and diabetes in offspring, but its relationship to non-alcoholic fatty liver disease (NAFLD) is unclear.
Through the nationwide ESPRESSO cohort study we identified all individuals ≤25 years of age in Sweden with biopsy-verified NAFLD diagnosed between 1992 and 2016 (n = 165). These were matched by age, sex, and calendar year with up to 5 controls (n = 717). Through linkage with the nationwide Swedish Medical Birth Register (MBR) we retrieved data on maternal early-pregnancy BMI, and possible confounders, in order to calculate adjusted odds ratios (aORs) for NAFLD in offspring.
Maternal BMI was associated with NAFLD in offspring: underweight (aOR 0.84; 95% CI 0.14-5.15), normal weight (reference, aOR 1), overweight (aOR 1.51; 0.95-2.40), and obese (aOR 3.26; 1.72-6.19) women. Severe NAFLD (biopsy-proven fibrosis or cirrhosis) was also more common in offspring of overweight (aOR 1.94; 95% CI 0.96-3.90) and obese (aOR 3.67; 95% CI 1.61-8.38) mothers. Associations were similar after adjusting for maternal pre-eclampsia and gestational diabetes. Socio-economic parameters (smoking, mother born outside the Nordic countries and less than 10 years of basic education) were also associated with NAFLD in offspring but did not materially alter the effect size of maternal BMI in a multivariable model.
This nationwide study found a strong association between maternal overweight/obesity and future NAFLD in offspring. Adjusting for socio-economic and metabolic parameters in the mother did not affect this finding, suggesting that maternal obesity is an independent risk factor for NAFLD in offspring.
In a study of all young persons in Sweden with a liver biopsy consistent with fatty liver, the authors found that compared to matched controls, the risk of fatty liver was much higher in those with obese mothers. This was independent of available confounders and suggests that the high prevalence of obesity in younger persons might lead to a higher risk of fatty liver in their offspring.
母体肥胖与后代心血管疾病和糖尿病的发生有关，但与非酒精性脂肪性肝病（NAFLD）的关系尚不清楚。
通过全国性的 ESPRESSO 队列研究，我们在瑞典发现了 1992 年至 2016 年间经活检证实的≤25 岁 NAFLD 患者（n=165）。按照年龄、性别和日历年份与最多 5 名对照者（n=717）进行匹配。通过与全国性的瑞典医疗出生登记处（MBR）的链接，我们获取了母亲早孕时 BMI 及可能的混杂因素的数据，以便计算后代患 NAFLD 的调整比值比（aOR）。
母亲 BMI 与后代的 NAFLD 相关：体重过轻（aOR 0.84；95%CI 0.14-5.15）、正常体重（参考，aOR 1）、超重（aOR 1.51；95%CI 0.95-2.40）和肥胖（aOR 3.26；95%CI 1.72-6.19）的女性。超重（aOR 1.94；95%CI 0.96-3.90）和肥胖（aOR 3.67；95%CI 1.61-8.38）母亲的后代中，严重的 NAFLD（经活检证实的纤维化或肝硬化）也更为常见。调整母亲先兆子痫和妊娠期糖尿病等母体因素后，相关性仍相似。社会经济参数（吸烟、母亲出生在北欧国家以外和受教育程度不足 10 年）与后代的 NAFLD 也有关，但在多变量模型中，母亲 BMI 的大小并未因这些参数的调整而发生明显改变。
本项全国性研究发现，母亲超重/肥胖与后代未来的 NAFLD 有很强的关联。调整母亲的社会经济和代谢参数并不能改变这一发现，这表明母亲肥胖是后代发生 NAFLD 的一个独立危险因素。
LAY SUMMARY 为非论文摘要，主要是对文章内容的通俗化总结，目的是让大众更好地了解文章内容，因此不需要翻译。
