1Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
2Faculty of Medicine and Medical Sciences, University of Balamand, Balamand, Lebanon.
3Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Background and aim: A recent study has demonstrated that women with gestational diabetes mellitus (GDM) are more likely to develop non-alcoholic fatty liver disease than those without GDM. In contrary to non-alcoholic fatty liver, the association of GDM with non-alcoholic steatohepatitis (NASH) has still not been well established in the current literature. Therefore, we aim to evaluate the association of a history of GDM and the development of NASH throughout their lives independently of type 2 diabetes mellitus (T2DM).
Methods: A validated research database of more than 360 hospitals was utilized to construct this study. Adult females included were divided into two groups: those with NASH (case) and individuals without NASH (control). Regression analysis was performed to account for potential cofounders.
Results: There were 70 632 640 individuals above the age of 18 years screened in the database. In patients with a history of GDM, NASH was most prevalent in middle age people compared with NASH alone, which was more prevalent in people aged 65 years and above. Compared with those without, patients with NASH tend to be Caucasian (odds ratio [OR]: 2.13), obese (OR: 4.83), have a history of GDM (OR: 1.23), diagnosed with hyperlipidemia (OR: 2.59), T2DM (OR: 4.52), metabolic syndrome (OR: 3.07), polycystic ovaries disease (OR: 1.72), and hypothyroidism (OR: 1.59).
Conclusion: We demonstrated for the first time an increased odd of developing NASH in women who have had a diagnosis of gestational diabetes mellitus throughout their lives independently of any other factors that could interfere with the results.