Endocrine Abstracts

Introduction: NAFLD has become the leading cause of liver disease in the Western world and has a strong association with obesity and diabetes. There are no studies of NAFLD in pregnant women.

Methods: Pregnant volunteers (n=57) were recruited in the first or third trimester and evaluated for the presence of NAFLD using abdominal ultrasound scans using accepted criteria. Liver biopsies were not performed since this invasive procedure would present undue risks in otherwise healthy pregnant subjects. Fasting liver enzymes (AST and ALT), triglycerides, adiponectin, leptin, glucose, and insulin, were drawn. Gestational diabetes was defined in third trimester subjects using criteria developed by Carpenter and Coustan. Subjects were subsequently subdivided into lean, obese, and gestational diabetics.

Results: Half of the subjects enrolled had ultrasound evidence of NAFLD. NAFLD was observed equally among those presenting in the first or third trimesters. Additionally, the prevalence of NAFLD was similar between those with normal BMI vs obese women. No liver enzymes elevations were encountered. Serum adiponectin levels were significantly higher in the lean subjects irrespective of gestational age while obese and gestational diabetic subjects had lower adiponectin concentrations. Serum leptin levels in the first trimester were significantly lower in lean subjects compared to the obese and GDM women. In the third trimester, levels were elevated (compared to first trimester levels) in the lean and obese, and gestational diabetic groups. No relationship between adipokine levels and the presence of NAFLD was detected.

Conclusions: This is the first study to report on NAFLD in pregnant women. Pregnant women with NAFLD have normal AST and ALT and hence, are not reliable diagnostic tests to distinguish NAFLD in pregnancy. Distribution of NAFLD is comparable in lean, obese and gestational diabetic subjects.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.