Intrauterine exposure to maternal type 1 diabetes (T1DM) is associated with a less favourable metabolic profile later in life. Fatty liver disease can be considered as the hepatic manifestation of the cluster of metabolic abnormalities linked to insulin resistance. This study aimed to evaluate the effect of maternal pregestational T1DM on the offspring’s risk of fatty liver disease and any association between maternal glycemic control during pregnancy and later risk of fatty liver disease in the offspring.

The study is a prospective nationwide follow-up study including offspring (n=277) born to mothers with pregestational T1DM between 1993-1999 and matched un-exposed controls (n=303). Age at the time of follow-up was 16.7 years (range 13.0-20.4 years). We used the Fatty Liver Index (FLI) and Waist-to-Height ratio (WHtR) to evaluate risk of fatty liver disease among the offspring. A FLI>60 or a WHtR>0.469 were used as indicators of fatty liver disease. Results are displayed in Table 1. More diabetes exposed offspring had high FLI and WHtR indices compared to un-exposed controls. Adjustment for maternal prepregnancy BMI, gender, age, and pubertal stage did not change overall results. No association between maternal glycemic control during pregnancy and risk of fatty liver disease was found.

Table 1: Comparison of indicators of fatty liver disease among offspring born to mothers with T1DM. 
 n Exposed Controls p-value 
  (n=277) (n=303)  
FLI < 30 495 229 (46) 266 (54)  
FLI>30 < 60 25 18 (72) 7 (28)  
FLI>60 14 9 (64) 5 (36) 0.02* 
WHtR <0.469 489 213 (44) 276 (56)  
WHtR >0.469 91 64 (70) 27 (30) <0.001* 
Table 1: Comparison of indicators of fatty liver disease among offspring born to mothers with T1DM. 
 n Exposed Controls p-value 
  (n=277) (n=303)  
FLI < 30 495 229 (46) 266 (54)  
FLI>30 < 60 25 18 (72) 7 (28)  
FLI>60 14 9 (64) 5 (36) 0.02* 
WHtR <0.469 489 213 (44) 276 (56)  
WHtR >0.469 91 64 (70) 27 (30) <0.001* 

Data are displayed as numbers and percent.

* Pearsons chi-squared test. FLI<30 rules out and FLI>60 as well as well as a WHtR>0.469 rules in fatty liver disease.

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Conclusion: Intrauterine exposure to maternal T1DM may predispose to fatty liver disease.

Disclosure

S. Knorr: None. B. Bytoft: None. Z. Lohse: None. T.D. Clausen: None. R.B. Jensen: None. P. Damm: Advisory Panel; Self; Novo Nordisk A/S. Other Relationship; Self; Novo Nordisk A/S. H. Beck-Nielsen: None. C.H. Gravholt: None. D.M. Jensen: None.

© 2018 by the American Diabetes Association.
2018
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