摘要
Nonalcoholic fatty liver disease (NAFLD) is the leading cause of liver disease in the Western world and has a strong relationship to obesity and diabetes. NAFLD has not been well studied in pregnant women. We studied a series of lean, obese, and gestational diabetic pregnant women and determined that liver enzymes would not serve to diagnose the presence of NAFLD in an obstetric population. A total of 59 pregnant women of various gestational ages and maternal weights who denied a history of alcohol intake or preexisting liver disease were recruited from a single-center university general obstetric clinic. Pregnant women underwent a maternal abdominal and obstetrical ultrasound, and blood samples were obtained for assays of liver enzymes, adiponectin and leptin. The presence of hepatic steatosis was established using standardized ultrasound criteria. NAFLD was detected by ultrasound in 48.9% of pregnant women and almost equally distributed between lean and obese women. The incidence of NAFLD in gestational diabetic pregnancies (50%) was comparable to the non-diabetic group with NAFLD in pregnant women. Adiponectin and leptin are similar between gravidas with and without NAFLD. Screening of pregnant women at any stage of pregnancy, early or late, lean or obese, or gestational diabetes after 26 weeks of gestation, would serve as a useful approach to determine NAFLD in pregnant women.
Nonalcoholic fatty liver disease (NAFLD) is the leading cause of liver disease in the Western world and has a strong relationship to obesity and diabetes. NAFLD has not been well studied in pregnant women. We studied a series of lean, obese, and gestational diabetic pregnant women and determined that liver enzymes would not serve to diagnose the presence of NAFLD in an obstetric population. A total of 59 pregnant women of various gestational ages and maternal weights who denied a history of alcohol intake or preexisting liver disease were recruited from a single-center university general obstetric clinic. Pregnant women underwent a maternal abdominal and obstetrical ultrasound, and blood samples were obtained for assays of liver enzymes, adiponectin and leptin. The presence of hepatic steatosis was established using standardized ultrasound criteria. NAFLD was detected by ultrasound in 48.9% of pregnant women and almost equally distributed between lean and obese women. The incidence of NAFLD in gestational diabetic pregnancies (50%) was comparable to the non-diabetic group with NAFLD in pregnant women. Adiponectin and leptin are similar between gravidas with and without NAFLD. Screening of pregnant women at any stage of pregnancy, early or late, lean or obese, or gestational diabetes after 26 weeks of gestation, would serve as a useful approach to determine NAFLD in pregnant women.
作者
V. Daniel Castracane
Glena Davis
Christopher G. Maguire
Urvi Shah
William A. Meachum
Robert P. Kauffman
V. Daniel Castracane;Glena Davis;Christopher G. Maguire;Urvi Shah;William A. Meachum;Robert P. Kauffman(Department of Obstetrics & Gynecology, School of Medicine, Texas Tech University Health Sciences Center at Permian Basin, Odessa, Texas, USA;Department of Obstetrics & Gynecology, School of Medicine, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas, USA)
