Association of maternal diabetes/glycosuria and pre-pregnancy body mass index with offspring indicators of non-alcoholic fatty liver disease

Patel, S., Lawlor, D. A., Callaway, M., Macdonald-Wallis, C., Sattar, N. and Fraser, A. (2016) Association of maternal diabetes/glycosuria and pre-pregnancy body mass index with offspring indicators of non-alcoholic fatty liver disease. BMC Pediatrics, 16, 47. (doi:10.1186/s12887-016-0585-y) (PMID:27036545) (PMCID:PMC4818433)

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Abstract

Background: Little is known about early life determinants of non-alcoholic fatty liver disease (NAFLD). We examined associations of maternal pregnancy diabetes/glycosuria and pre-pregnancy body mass index (BMI) with offspring markers of NAFLD and liver pathology and examined mediation by birthweight and concurrent offspring adiposity. Methods: We used data from a UK prospective pregnancy cohort. Offspring underwent abdominal ultrasonography (USS) at mean age 17.8 years. Outcomes included USS-assessed fatty liver, estimated liver volume and shear velocity, a variant of elastography (a marker of liver fibrosis) (N = 1 215) and blood-based markers of liver pathology [alanine amino transferase, aspartate amino transferase, gamma- glutamyltransferase and haptoglobin] (N = 2 359). Results: 2.1 % (N = 25) of participants had USS-assessed fatty liver [maternal diabetes/glycosuria (N = 7) and no diabetes/glycosuria (N = 18)]. Maternal diabetes/glycosuria was associated with greater odds of offspring USS fatty liver in confounder adjusted models [adjusted odds ratio (aOR) 6.74 (95 % confidence interval (CI) 2.47, 18.40)] and higher shear velocity [adjusted ratio of geometric mean (aRGM):1.10 (95 % CI 1.05, 1.15)]. These associations were not mediated by offspring birthweight or concurrent adiposity. Maternal diabetes/glycosuria was not associated with liver volume or blood-based outcomes. Greater maternal pre-pregnancy BMI was associated with greater odds of offspring USS fatty liver [aOR 2.72 (95 % CI: 1.20, 6.15)], higher liver volume [aRGM 1.03 (95 % CI 1.00, 1.07)] and shear velocity [aRGM1.03 (95 % CI: 1.01, 1.06)] in confounder adjusted models. These associations were largely mediated by offspring adiposity. Maternal pre-pregnancy BMI was not consistently associated with blood-based outcomes. Conclusions: Results suggest that maternal pregnancy diabetes/glycosuria is associated with offspring NAFLD through mechanisms other than offspring’s own adiposity.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Sattar, Professor Naveed
Authors: Patel, S., Lawlor, D. A., Callaway, M., Macdonald-Wallis, C., Sattar, N., and Fraser, A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:BMC Pediatrics
Journal Abbr.:BMC Pediatr
Publisher:BioMed Central
ISSN:1471-2431
ISSN (Online):1471-2431
Published Online:31 March 2016
Copyright Holders:Copyright © 2016 Patel et al.
First Published:First published in BMC Pediatrics 16:47
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
494152The utility of biomarkers for non-alcoholic fatty liver disease in adolescentsNaveed SattarMedical Research Council (MRC)G0801456/88195RI CARDIOVASCULAR & MEDICAL SCIENCES
565111Modifiable early life determinants of adolescent NAFLD and its association with metabolic and vascular traitsNaveed SattarBritish Heart Foundation (BHF)PG/11/33/28794RI CARDIOVASCULAR & MEDICAL SCIENCES