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Cited by 59Gestational Diabetes Research and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsLiver Disease Diagnosis and Treatment

Pregravid liver enzyme levels and risk of gestational diabetes mellitus during a subsequent pregnancy

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Sridhar, Sneha B., Xu, Fei, Darbinian, Jeanne, Quesenberry, Charles P., Ferrara, Assiamira, Hedderson, Monique M.·2014·Diabetes Care
DOI 10.2337/dc13-2229PMC PMC4067389
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Abstract

OBJECTIVE: Liver enzymes are independent predictors of type 2 diabetes. Although liver fat content correlates with features of insulin resistance, a risk factor for developing gestational diabetes mellitus (GDM), the relationship between liver enzymes and GDM is unclear. The objective of this study was to assess whether pregravid liver enzyme levels are associated with subsequent risk of GDM. RESEARCH DESIGN AND METHODS: A nested case-control study was conducted among women who participated in the Kaiser Permanente Northern California multiphasic health checkup (1984–1996) and had a subsequent pregnancy (1984–2009). Case patients were 256 women who developed GDM. Two control subjects were selected for each case patient and matched for year of blood draw, age at examination, age at pregnancy, and number of intervening pregnancies. RESULTS: Being in the highest quartile versus the lowest quartile of γ-glutamyl transferase (GGT) levels was associated with a twofold increased risk of subsequent GDM (odds ratio 1.97 [95% CI 1.14–3.42]), after adjusting for race/ethnicity, prepregnancy BMI, family history of diabetes, and alcohol use. This result was attenuated after adjusting for homeostasis model assessment of insulin resistance (HOMA-IR), fasting status, and rate of gestational weight gain. There was significant interaction between GGT and HOMA-IR; the association with GGT was found among women in the highest tertile of HOMA-IR. Aspartate aminotransferase and alanine aminotransferase were not associated with increased GDM risk. CONCLUSIONS: Pregravid GGT level, but not alanine aminotransferase or aspartate aminotransferase level, predicted the subsequent risk of GDM. Markers of liver fat accumulation, such as GGT level, are present years before pregnancy and may help to identify women at increased risk for subsequent GDM.

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  • Thyroid dysfunction and diabetes mellitus are closely linked, and the liver is the main organ of glucose metabolism in the human.

    “Thyroid dysfunction and diabetes mellitus are closely linked, and the liver is the main organ of glucose metabolism in the human (Biondi et al., 2019; Sridhar et al., 2014).”

    From Exposure to per- and polyfluoroalkyl substances in early pregnancy, risk of gestational diabetes mellitus, potential pathways, and influencing factors in pregnant women: A nested case-control study (2023) · cites this paper as Sridhar et al., 2014

    Sridhar et al. is relevant to the liver portion of the sentence: the Introduction says the liver is crucial to glucose homeostasis during fasting and after meals. It does not establish the stronger claim that the liver is the main organ of human glucose metabolism. The thyroid–diabetes portion is also cited to Biondi et al. and is not the part assessed here. (LLM, conf=0.84)

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Cited by

Sorted by citations

Authors
Sridhar, S. B., Xu, F., Darbinian, J., Quesenberry, C. P., Ferrara, A., & Hedderson, M. M.
Affiliations
Kaiser Permanente (US)
Corresponding author
Sridhar, Sneha B.
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2014-06-12
Volume
37
Issue
7
Pages
1878-1884
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc13-2229
PMC
PMC4067389
OpenAlex
W2003514512
Cited by
59
References
4
Citations by year
2026: 4 · 2025: 4 · 2024: 4 · 2023: 7 · 2022: 5 · 2021: 4 · 2020: 4 · 2019: 5 · 2018: 5 · 2017: 3 · 2016: 8 · 2015: 3 · 2014: 3
FWCI
6.03
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Care (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
  • Kaiser Permanente
  • National Institutes of Health
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK092924)
  • National Institute of Child Health and Human Development
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD065904)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
Keywords
gestational diabetes mellitus, gamma-glutamyl transferase, liver enzymes, insulin resistance, HOMA-IR, aspartate aminotransferase, alanine aminotransferase, type 2 diabetes risk, pregnancy risk prediction, Kaiser Permanente Northern California
MeSH terms
Adult, California, Fasting, Female, Humans, Insulin Resistance, Liver, Pregnancy, Risk, Risk Factors, Weight Gain, Case-Control Studies, Diabetes, Gestational, Young Adult

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