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Medical/Surgical/Diseases/Complications

Poster Session 3

(694) Pregnancy Dysglycemia and Predicted Risk of Fatty Liver Disease 10-14 Years after Delivery

Wednesday, February 14, 2024

8:30 AM – 10:00 AM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Presenting Author(s)

Christine P. Field, MD, MPH (she/her/hers)

Maternal Fetal Medicine Fellow
Ohio State University / Department of OB/GYN / Division of Maternal Fetal Medicine
Columbus, OH, United States

Coauthor(s)

vm

vidya mulangi, BS

The Ohio State University
Columbus, OH, United States
JW

Jiqiang Wu, MSc

Ohio State University
Columbus, OH, United States
Patrick Catalano, MD

Professor
Tufts Medical Center
Boston, MA, United States
Mark B. Landon, MD

Richard L. Meiling Professor and Chair, Obstetrics and Gynecology
The Ohio State University Wexner Medical Center
Columbus, OH, United States
DS

Denise Scholtens, PhD

Northwestern University
Chicago, IL, United States
WL

William Lowe, MD

Northwestern University
Chicago, IL, United States
William A. Grobman, MD, MBA

Professor
The Ohio State University
Columbus, Ohio, United States

Primary Author(s)

Kartik K. Venkatesh, MD, PhD (he/him/his)

Ohio State University
Columbus, OH, United States

Objective: To determine whether pregnancy dysglycemia is associated with higher 6-year predicted risk of non-alcoholic fatty liver disease (NAFLD), as quantified by the Framingham Risk Calculator, 10-14 years after delivery.

Study Design: A secondary analysis from the prospective Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Follow-up Study. The exposures examined were maternal dysglycemia defined by summary z-score using fasting, 1-, and 2-hour values of a 75-gram oral glucose tolerance test (OGTT) at 24-32 weeks’ gestation, and secondarily by diagnosis of GDM per IADPSG criteria The primary outcome was the predicted 6-year NAFLD risk using the Framingham Risk Calculator modelled either as a continuous measure or in tertiles from lowest (tertile 1, [T1]) to highest predicted risk (T3). Linear and modified Poisson regression models adjusted for baseline covariates at the time of the OGTT, including study field center, age, parity, and gestational age at OGTT.

Results:

Of 4,697 individuals in the analytic sample, the median age was 30.5 (IQR: 26.0,34.1) and the median BMI was 26.6 (IQR: 24.1,29.9) at baseline. A total of 14.3% (n=672) developed GDM. At 10-14 years after delivery (median 11.6, IQR: 10.8, 12.4), the median predicted 6-year risk of NAFLD was 13% (IQR: 3, 13). Individuals with a higher OGTT summary z-score were at higher predicted risk of NAFLD (adj. beta coefficient: 3.1 per 1 SD; 95% CI: 2.7, 3.6), as were those who were diagnosed with GDM (adj. beta coefficient: 4.3; 95% CI: 3.1, 5.4). Individuals with higher OGTT summary z-scores were also more likely to be in the highest tertile of NAFLD predicted risk (adj. RR: 1.2 per 1 SD; 95% CI: 1.0, 1.3), but those who had GDM were not more likely to be in the highest tertile of predicted risk.

Conclusion:

Increasing dysglycemia in pregnancy is associated with a higher predicted risk of NAFLD 10-14 years after delivery. Postpartum prevention of cardiometabolic risk factors for NAFLD among individuals with pregnancy dysglycemia requires further investigation.