The common risk factor for both gestational diabetes and
non-alcoholic fatty liver disease, researchers say, is trouble
making or using the hormone insulin to manage blood sugar, known as
“We hope that early identification can promote healthy lifestyle
changes that prevent or slow disease progression,” said lead author
Dr. Veeral Ajmera of the University of California, San Francisco.
“Pregnancy stresses the body in many ways, one of which is the
ability to manage blood sugar,” Ajmera said by email. “During
pregnancy a woman's body becomes more resistant to insulin, which is
the hormone required to decrease the blood sugar.”
Insulin resistance is also “central to development of non-alcoholic
fatty liver disease,” which affects 20 percent to 30 percent of
adults in the western world, the study team writes in The American
Journal of Gastroenterology. Non-alcoholic fatty liver disease is
the most common chronic liver disease in the United States.
Fatty liver disease is often diagnosed later in life, Ajmera told
Reuters Health. So the researchers used long-term data to see if
diabetes during pregnancy made a woman more likely to develop fatty
liver disease 25 years later.
The researchers analyzed information about 1,115 black and white
women recruited between 1985-1986 in four cities across the United
States who gave birth to at least one child.
The participants did not have diabetes before becoming pregnant and
the study excluded people who had liver issues related to alcohol,
HIV, hepatitis or medications.
At the start of the study, women reported on whether they first
experienced diabetes during pregnancy, and researchers confirmed the
diagnosis with blood test results. Twenty-five years later, the
women received more blood tests as well as CT scans of their livers
to check if they had fatty liver disease.
At the beginning of the study, 124 women reported that they
developed diabetes while they were pregnant. These women were more
likely than those who did not experience gestational diabetes to be
overweight. They also had higher degrees of insulin resistance when
they were younger as well as at the 25-year follow up.
The women who experienced diabetes during pregnancy were also more
likely to have developed diabetes again at some point in the
following 25 years.
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Overall, 75 women were diagnosed with non-alcoholic fatty liver
disease when they were middle aged. Women who had diabetes during
pregnancy were more than twice as likely as those who didn’t to
later develop fatty liver disease.
After researchers adjusted for diabetes that some women experienced
outside of pregnancy, the risk of non-alcoholic fatty liver disease
was still 50 percent higher for women who had gestational diabetes
compared to those who didn’t.
Fatty liver disease can have grave health effects and can even lead
to cirrhosis, a condition that causes liver damage and possible
failure, said Simon Taylor-Robinson, a professor of medicine at
Imperial College London in the U.K. who wasn’t involved in the
He advocates changes in diet to avoid the insulin resistance that
leads to diabetes and fatty liver disease. “Many women are obese –
so it is a matter of reducing weight and eating sensibly,” he said.
Taylor-Robinson recommends eating fewer carbohydrates, more proteins
and vegetables, and in particular, avoiding large amounts of fruit
juice, which can contain a lot of sugar.
Ajmera also advised lifestyle changes, especially adding exercise.
“We recommend either aerobic or resistance training for 30 minutes
five times per week,” he said.
“There are consequences to obesity and this includes cirrhosis,
liver cancer and heart disease,” Taylor-Robinson said. “Those people
who become diabetic during pregnancy have strong risks of developing
these complications later in life if attention isn’t given to
weight, diet and exercise.”
SOURCE: http://bit.ly/1qjVUo0 American Journal of Gastroenterology,
online March 22, 2016.
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