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Gestational Diabetes Associated with Postpartum NAFLD Risk Meta-Analysis: Evidence for Sustained Metabolic

Milica Stoiljkovic1,2, Katarina Lalic1,2, Tanja Milicic1,2

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Women with a history of gestational diabetes (GD) face a significantly increased and persistent risk of developing non-alcoholic fatty liver disease (NAFLD) long after pregnancy. This highlights GD as an early indicator for future liver health issues.

Keywords:
gestational diabeteslong-term risk metabolic dysfunctionmeta-analysisnon-alcoholic fatty liver disease

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Area of Science:

  • Metabolic Health
  • Hepatology
  • Obstetrics & Gynecology

Background:

  • Gestational diabetes (GD) is a known risk factor for future metabolic disorders.
  • The long-term, time-dependent risk of non-alcoholic fatty liver disease (NAFLD) following GD is not well understood.
  • Understanding this association is crucial for identifying women at high risk for liver disease.

Purpose of the Study:

  • To quantify the long-term risk of NAFLD in women with a history of GD.
  • To determine if the elevated risk of NAFLD persists beyond the postpartum period.

Main Methods:

  • A systematic literature search was conducted in PubMed to identify relevant studies.
  • Included studies compared NAFLD incidence in women with prior GD versus those with normal glucose tolerance (NGT).
  • Meta-analysis of four studies (N=2873) with follow-up beyond pregnancy was performed.

Main Results:

  • Women with previous GD had 2.46 times higher odds of developing NAFLD compared to women with NGT (p < 0.001).
  • The risk of NAFLD did not significantly change over time since delivery (p = 0.901).
  • The association between prior GD and NAFLD risk is sustained long-term.

Conclusions:

  • Gestational diabetes is linked to a significantly increased and sustained risk of NAFLD.
  • This risk persists for decades after pregnancy, underscoring GD as an early marker for liver outcomes.
  • Long-term metabolic screening and preventive strategies are essential for women with a history of GD.