Oral Presentation International Association of the Diabetes and Pregnancy Study Groups 2022 - Hosted by ADIPS

Serial FibroScan® Controlled Attenuation Parameter (CAP) scores were improved in pregnant women treated for gestational diabetes mellitus (#16)

Thora Y Chai 1 2 3 , Difei Deng 2 , Karen Byth 2 , Jacob George 2 4 , Dharmintra Pasupathy 5 , N Wah Cheung 1 2 5
  1. Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, NSW, Australia
  2. Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
  3. Reproduction and Perinatal Centre, The University of Sydney, Camperdown, NSW, Australia
  4. Storr Liver Centre, Westmead Institute for Medical Research, Westmead, NSW, Australia
  5. Reproduction and Perinatal Centre, The University of Sydney, Camperdown, NSW, Australia

Aims:

To assess for changes in hepatic steatosis during pregnancy using the FibroScan® Controlled Attenuation Parameter (CAP) score and to determine its relationship with gestational diabetes mellitus (GDM) and gestational weight gain.

Methods:

A prospective longitudinal cohort study was conducted on singleton pregnant women enrolled from a multiethnic obstetrics service in Sydney, Australia. Women were advised to fast for at least 2 hours prior to their FibroScan®. A recruitment FibroScan® was performed between 10–24 weeks and a second FibroScan® between 30–36 weeks. A change in CAP (difference between serial and recruitment CAP) was calculated, along with whether CAP was reduced. GDM was diagnosed with the 1998 Australasian Diabetes in Pregnancy (ADIPS) diagnostic criteria. Maternal weight (kg) was collected at recruitment, serial FibroScan® and 1 week prior to delivery. Gestational weight gain was categorised as below, recommended and excess according to the Institute of Medicine (IOM). The cohort were separated by GDM status and categorical variables were compared with Pearson’s chi–squared test or Fisher’s exact test, and continuous variables with Mann–Whitney U test. Multiple logistic regression analysis was used to determine the predictors for a reduction in CAP, with odds ratios (OR) and 95% confidence intervals (CI) reported.

Results:

Three hundred and twenty–eight women were enrolled, where 263 had recruitment and serial FibroScan® performed and 250 were appropriately fasted prior to their FibroScan®. Of these, 56 (22.4%) women had GDM and were seen in the GDM clinic with multidisciplinary support. GDM women had similar recruitment body mass index (BMI) to non–GDM women (median 27.0, IQR 24.4–31.1kg/m2 vs. median 26.5, IQR 23.8–31.2kg/m2, p=0.64), but gained less weight between the two FibroScans® (median 5.15, IQR 2.2–7.0kg vs. median 6.3, IQR 4.2–9.0kg, p<0.01). Recruitment CAP scores were higher in GDM than non–GDM women (median 240, IQR 208–267dB/m vs. median 223, IQR 199–249dB/m, p=0.03) and their CAP scores improved more during pregnancy (median change -10, IQR -37–13 vs. median change -4, IQR -16–11, p=0.04). With IOM gestational weight gain targets, GDM–treated women were more likely to achieve below weight gain targets (48.2% vs. 21.6%, p<0.01). After adjustment for recruitment BMI and GDM status, a greater reduction in CAP was significantly associated with below target gestational weight gain (adjusted OR 2.10, 95% CI 1.11–3.99, p=0.02).

Conclusions:

Serial FibroScan® CAP scores were improved in women with GDM. This was significantly associated with below target gestational weight gain, possibly from more intensive lifestyle management achieved in GDM–affected women.