Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Diabetes Res Clin Pract. 2022 Sep;191:110038. doi: 10.1016/j.diabres.2022.110038. Epub 2022 Aug 13.
To determine the prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) and its association on adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM).
380 women with GDM had a FibroScan® performed between 24 and 32 weeks. A Controlled Attenuation Parameter (CAP) ≥ 233.5 dB/m signified MAFLD. Gestational hypertension, pre-eclampsia and eclampsia contributed to a composite of adverse maternal outcomes. A composite of adverse neonatal outcomes included pre-term birth, hypoglycaemia, small/large-for-gestational age and admission to neonatal high dependency. Multiple logistic regression was used to determine independent associations with MAFLD.
147 (38.7 %) women had MAFLD. Higher pre-pregnancy BMI (median 28.4, IQR 24.7-33.0 kg/m vs median 24.0, IQR 21.7-26.5 kg/m, p < 0.01) and rates of insulin therapy (62.2 % vs 40.7 %, p < 0.01) occurred in MAFLD over non-MAFLD women. MAFLD was independently associated with obesity (aOR 4.73 [95 % CI 2.53-8.86]) and insulin therapy (aOR 1.79 [95 % CI 1.12-2.85]). MAFLD and non-MAFLD women had comparable rates of adverse maternal (7.7 % vs 9.5 %, p = 0.56) and neonatal outcomes (75.4 % vs 68.8 %, p = 0.18).
Within this GDM cohort, almost 40% had FibroScan®-detected MAFLD in mid-to-late gestation. MAFLD was not associated with worse pregnancy outcomes.
确定代谢功能障碍相关脂肪性肝病（MAFLD）在患有妊娠期糖尿病（GDM）的女性中的流行率及其与不良妊娠结局的关系。
380 名 GDM 女性在 24 至 32 周之间进行了 FibroScan®检查。受控衰减参数（CAP）≥233.5dB/m 表示 MAFLD。妊娠高血压、先兆子痫和子痫导致了不良母亲结局的综合表现。不良新生儿结局的综合表现包括早产、低血糖、小于胎龄儿或大于胎龄儿以及新生儿高依赖病房入院。多变量逻辑回归用于确定与 MAFLD 相关的独立因素。
147 名（38.7%）女性患有 MAFLD。MAFLD 女性的孕前 BMI 更高（中位数 28.4，IQR 24.7-33.0kg/m 与中位数 24.0，IQR 21.7-26.5kg/m，p<0.01），胰岛素治疗率（62.2%比 40.7%，p<0.01）也更高。MAFLD 与肥胖（优势比 4.73 [95%置信区间 2.53-8.86]）和胰岛素治疗（优势比 1.79 [95%置信区间 1.12-2.85]）独立相关。MAFLD 和非 MAFLD 女性的不良母亲（7.7%比 9.5%，p=0.56）和新生儿结局（75.4%比 68.8%，p=0.18）的发生率相当。
在这个 GDM 队列中，近 40%的女性在妊娠中期到晚期通过 FibroScan®检测出 MAFLD。MAFLD 与妊娠结局恶化无关。
