Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Diabetes Res Clin Pract. 2022 Jul;189:109942. doi: 10.1016/j.diabres.2022.109942. Epub 2022 Jun 9.
Non-invasive hepatic steatosis indices can be used to assess the risk for metabolic (dysfunction) associated fatty liver disease (MAFLD). This may be helpful to detect metabolic disorders in pregnancy, specifically gestational diabetes (GDM). We aimto examine the association of these indices with parameters of glucose metabolism.
109 women underwent a metabolic characterization at 16 weeks of gestation andwere classified according to the fatty-liver index (FLI) andhepatic-steatosis index (HSI) into low (G1), intermediate (G2) and high risk (G3). At 26 weeks, participants received an oral glucose tolerance test (OGTT) to assess insulin action, β-cell function and GDM status.
Both MAFLD indices wereassociated with impaired insulin sensitivityand compensatory increase of insulin release. G3 groups showedimpaired insulin action. The higher circulating insulin concentrations were not able to compensate for insulin resistance in women with higher MAFLD scores, resulting in an increased risk of GDM(OR: 1.05, 95% CI 1.03 to 1.08, p < 0.001 for FLI). MAFLD scores were associated with fetal overgrowth.
Maternal MAFLD represents a high-risk obstetric condition. Hepatic steatosis indices are associated with impaired glucose regulation and may provide a useful tool for early risk assessment for impaired glucose metabolism.
非侵入性肝脂肪变性指数可用于评估代谢（功能）相关脂肪性肝病（MAFLD）的风险。这可能有助于在怀孕期间发现代谢紊乱，特别是妊娠期糖尿病（GDM）。我们旨在研究这些指数与糖代谢参数之间的关联。
109 名女性在妊娠 16 周时进行了代谢特征分析，并根据脂肪肝指数（FLI）和肝脂肪变性指数（HSI）将其分为低危（G1）、中危（G2）和高危（G3）组。在 26 周时，参与者接受口服葡萄糖耐量试验（OGTT）以评估胰岛素作用、β细胞功能和 GDM 状态。
两种 MAFLD 指数均与胰岛素敏感性受损和胰岛素分泌代偿性增加相关。G3 组表现出胰岛素作用受损。循环胰岛素浓度的升高不能代偿 MAFLD 评分较高女性的胰岛素抵抗，导致 GDM 的风险增加（OR：1.05，95%CI 1.03 至 1.08，p<0.001，FLI）。MAFLD 评分与胎儿过度生长有关。
母体 MAFLD 代表一种高危产科情况。肝脂肪变性指数与糖调节受损相关，可能为早期评估糖代谢受损提供有用的工具。
