Fatty liver index predicts further metabolic deteriorations in women with previous gestational diabetes.

<h4>Background and aims</h4>Determinants of fatty liver (FL) might be predictive for further deterioration in insulin resistance (IR) in women with previous gestational diabetes (pGDM). The aim was to evaluate the association between pGDM, FL and future manifestation of type 2 diabetes (...

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Autores principales:	Latife Bozkurt, Christian S Göbl, Andrea Tura, Marek Chmelik, Thomas Prikoszovich, Lana Kosi, Oswald Wagner, Michael Roden, Giovanni Pacini, Amalia Gastaldelli, Alexandra Kautzky-Willer
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/7a00980599744942a2d57fe2f427893e
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spelling	oai:doaj.org-article:7a00980599744942a2d57fe2f427893e2021-11-18T07:26:22ZFatty liver index predicts further metabolic deteriorations in women with previous gestational diabetes.1932-620310.1371/journal.pone.0032710https://doaj.org/article/7a00980599744942a2d57fe2f427893e2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22393439/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background and aims</h4>Determinants of fatty liver (FL) might be predictive for further deterioration in insulin resistance (IR) in women with previous gestational diabetes (pGDM). The aim was to evaluate the association between pGDM, FL and future manifestation of type 2 diabetes (T2DM) by a detailed pathophysiological characterization early after pregnancy.<h4>Methods</h4>68 pGDM and 29 healthy controls were included 3-6 months after delivery and underwent specific metabolic assessments: status of IR was determined via oral- and intravenous-glucose-tolerance-tests with analysis of proinflammatory factors and kinetics of free-fatty-acids (FFA). According to the fatty-liver-index (FLI), pGDMs were categorized into three groups with low (FLI≤20), intermediate (20<FLI<60) and high (FLI≥60) risk for FL to assess differences in metabolic parameters at baseline as well as in the 10-year incidence for T2DM. Accuracy of FLI was proven with 1H-magnetic-resonance-spectroscopy.<h4>Results</h4>FL was strongly associated with IR in pGDM. pGDM with FLI≥60 showed significantly increased interleukin-6, plasminogen-activator-inhibitor-1, tissue-plasminogen-activator, fibrinogen and increased ultrasensitive-C-reactive-protein compared to the low risk group (FLI≤20). Analysis of FFA indicated a less pronounced decrease of plasma FFA levels during the oral-glucose-tolerance-test in subjects with FLI≥60. History of GDM plus FLI≥60 conferred a high risk for the manifestation of diabetes over 10 years of observation as compared to pGDMs with FLI≤20 (HR:7.85, Cl:2.02-30.5, p = 0.003).<h4>Conclusion</h4>FL is closely linked to GDM, especially to IR and inflammation. Most interestingly, subjects with the highest FLI values showed significant alterations in FFA kinetics and a higher risk to develop T2DM in future.Latife BozkurtChristian S GöblAndrea TuraMarek ChmelikThomas PrikoszovichLana KosiOswald WagnerMichael RodenGiovanni PaciniAmalia GastaldelliAlexandra Kautzky-WillerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 2, p e32710 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Latife Bozkurt Christian S Göbl Andrea Tura Marek Chmelik Thomas Prikoszovich Lana Kosi Oswald Wagner Michael Roden Giovanni Pacini Amalia Gastaldelli Alexandra Kautzky-Willer Fatty liver index predicts further metabolic deteriorations in women with previous gestational diabetes.
description	<h4>Background and aims</h4>Determinants of fatty liver (FL) might be predictive for further deterioration in insulin resistance (IR) in women with previous gestational diabetes (pGDM). The aim was to evaluate the association between pGDM, FL and future manifestation of type 2 diabetes (T2DM) by a detailed pathophysiological characterization early after pregnancy.<h4>Methods</h4>68 pGDM and 29 healthy controls were included 3-6 months after delivery and underwent specific metabolic assessments: status of IR was determined via oral- and intravenous-glucose-tolerance-tests with analysis of proinflammatory factors and kinetics of free-fatty-acids (FFA). According to the fatty-liver-index (FLI), pGDMs were categorized into three groups with low (FLI≤20), intermediate (20<FLI<60) and high (FLI≥60) risk for FL to assess differences in metabolic parameters at baseline as well as in the 10-year incidence for T2DM. Accuracy of FLI was proven with 1H-magnetic-resonance-spectroscopy.<h4>Results</h4>FL was strongly associated with IR in pGDM. pGDM with FLI≥60 showed significantly increased interleukin-6, plasminogen-activator-inhibitor-1, tissue-plasminogen-activator, fibrinogen and increased ultrasensitive-C-reactive-protein compared to the low risk group (FLI≤20). Analysis of FFA indicated a less pronounced decrease of plasma FFA levels during the oral-glucose-tolerance-test in subjects with FLI≥60. History of GDM plus FLI≥60 conferred a high risk for the manifestation of diabetes over 10 years of observation as compared to pGDMs with FLI≤20 (HR:7.85, Cl:2.02-30.5, p = 0.003).<h4>Conclusion</h4>FL is closely linked to GDM, especially to IR and inflammation. Most interestingly, subjects with the highest FLI values showed significant alterations in FFA kinetics and a higher risk to develop T2DM in future.
format	article
author	Latife Bozkurt Christian S Göbl Andrea Tura Marek Chmelik Thomas Prikoszovich Lana Kosi Oswald Wagner Michael Roden Giovanni Pacini Amalia Gastaldelli Alexandra Kautzky-Willer
author_facet	Latife Bozkurt Christian S Göbl Andrea Tura Marek Chmelik Thomas Prikoszovich Lana Kosi Oswald Wagner Michael Roden Giovanni Pacini Amalia Gastaldelli Alexandra Kautzky-Willer
author_sort	Latife Bozkurt
title	Fatty liver index predicts further metabolic deteriorations in women with previous gestational diabetes.
title_short	Fatty liver index predicts further metabolic deteriorations in women with previous gestational diabetes.
title_full	Fatty liver index predicts further metabolic deteriorations in women with previous gestational diabetes.
title_fullStr	Fatty liver index predicts further metabolic deteriorations in women with previous gestational diabetes.
title_full_unstemmed	Fatty liver index predicts further metabolic deteriorations in women with previous gestational diabetes.
title_sort	fatty liver index predicts further metabolic deteriorations in women with previous gestational diabetes.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/7a00980599744942a2d57fe2f427893e
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Fatty liver index predicts further metabolic deteriorations in women with previous gestational diabetes.

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