Diabetes during pregnancy linked to liver disease later in life

Last Updated: 2016-03-31

By Madeline Kennedy

(Reuters Health) - Women who develop gestational diabetes may be at elevated risk of also developing non-alcoholic fatty liver disease (NAFLD) when they reach middle age, according to a new analysis.

The common risk factor for both gestational diabetes and NAFLD is insulin resistance, the researchers say.

NAFLD is often diagnosed later in life. So the researchers used long-term data to see if diabetes during pregnancy made a woman more likely to develop NAFLD 25 years later, and reported their findings March 22 in The American Journal of Gastroenterology.

Dr. Veeral Ajmera, of the University of California, San Francisco, and colleagues analyzed data on 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.

At the beginning of the study, 124 women reported a history of gestational diabetes. 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.

Overall, 75 women were diagnosed with NAFLD 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 NAFLD was still 50% 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, said Simon Taylor-Robinson, a professor of medicine at Imperial College London in the U.K. who wasn't involved in the study.

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

Am J Gastroenterol 2016.