PMID- 37253998
OWN - NLM
STAT- MEDLINE
DCOM- 20230814
LR  - 20230814
IS  - 1573-7284 (Electronic)
IS  - 0393-2990 (Linking)
VI  - 38
IP  - 8
DP  - 2023 Aug
TI  - Synergistic effect of non-alcoholic fatty liver disease and history of 
      gestational diabetes to increase risk of type 2 diabetes.
PG  - 901-911
LID - 10.1007/s10654-023-01016-1 [doi]
AB  - Whether non-alcoholic fatty liver disease (NAFLD) improves risk prediction for 
      subsequent type 2 diabetes mellitus (T2DM) in women with prior gestational 
      diabetes mellitus (pGDM) is uncertain. We examined the combined effects of NAFLD 
      and pGDM on risk prediction for incident T2DM. This retrospective cohort study 
      included 97,347 Korean parous women without diabetes mellitus at baseline whose 
      mean (SD) age was 39.0 (7.8) years. Cox proportional hazards models were used to 
      estimate hazard ratios (HRs) for incident T2DM according to self-reported pGDM 
      and ultrasound-diagnosed NAFLD at baseline. When combined with conventional 
      diabetes risk factors, the incremental predictive ability of NAFLD and pGDM to 
      identify incident T2DM was assessed. During a median follow-up of 3.9 years, 
      1,515 cases of incident T2DM occurred. Multivariable-adjusted HRs (95% confidence 
      intervals [CIs]) for incident T2DM comparing pGDM alone, NAFLD alone, and both 
      NAFLD and pGDM to the reference (neither NAFLD nor pGDM) were 2.61 (2.06-3.31), 
      2.26 (1.96-2.59), and 6.45 (5.19-8.00), respectively (relative excess risk of 
      interaction = 2.58 [95% CI, 1.21-3.95]). These associations were maintained after 
      adjusting for insulin resistance, body mass index, and other potential 
      confounders as time-dependent covariates. The combination of NAFLD and pGDM 
      improved risk prediction for incident T2DM (based on Harrell's C-index, also 
      known as the concordance index, and net reclassification improvement) compared to 
      conventional diabetes risk factors. In conclusion, NAFLD synergistically 
      increases the risk of subsequent T2DM in women with pGDM. The combination of 
      NAFLD and pGDM improves risk prediction for T2DM.
CI  - (c) 2023. Springer Nature B.V.
FAU - Cho, Yoosun
AU  - Cho Y
AD  - Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School 
      of Medicine, Seoul, Republic of Korea.
FAU - Chang, Yoosoo
AU  - Chang Y
AD  - Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University 
      School of Medicine, Seoul, Republic of Korea. yoosoo.chang@gmail.com.
AD  - Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, 
      Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250, 
      Taepyung-ro 2ga, Jung-gu, Seoul, 04514, Republic of Korea. 
      yoosoo.chang@gmail.com.
AD  - Department of Clinical Research Design & Evaluation, Samsung Advanced Institute 
      for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of 
      Korea. yoosoo.chang@gmail.com.
FAU - Ryu, Seungho
AU  - Ryu S
AUID- ORCID: 0000-0002-3927-8646
AD  - Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University 
      School of Medicine, Seoul, Republic of Korea. sh703.yoo@gmail.com.
AD  - Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, 
      Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250, 
      Taepyung-ro 2ga, Jung-gu, Seoul, 04514, Republic of Korea. sh703.yoo@gmail.com.
AD  - Department of Clinical Research Design & Evaluation, Samsung Advanced Institute 
      for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of 
      Korea. sh703.yoo@gmail.com.
FAU - Wild, Sarah H
AU  - Wild SH
AD  - Usher Institute, University of Edinburgh, Edinburgh, U.K.
FAU - Byrne, Christopher D
AU  - Byrne CD
AD  - Nutrition and Metabolism, Faculty of Medicine, University of Southampton, 
      Southampton, U.K.
AD  - National Institute for Health and Care Research Southampton Biomedical Research 
      Centre, University Hospital Southampton, Southampton, U.K.
LA  - eng
GR  - SKKU Excellence in Research Award Research Fund/Sungkyunkwan University/
GR  - NRF-2021R1A2C1012626/National Research Foundation of Korea/
GR  - NIHR203319/Southampton National Institute for Health Research Biomedical Research 
      Centre/
PT  - Journal Article
DEP - 20230531
PL  - Netherlands
TA  - Eur J Epidemiol
JT  - European journal of epidemiology
JID - 8508062
SB  - IM
MH  - Pregnancy
MH  - Humans
MH  - Female
MH  - Adult
MH  - *Non-alcoholic Fatty Liver Disease/epidemiology
MH  - *Diabetes Mellitus, Type 2/epidemiology
MH  - *Diabetes, Gestational/epidemiology
MH  - Retrospective Studies
MH  - Incidence
MH  - Risk Factors
OTO - NOTNLM
OT  - Cohort study
OT  - Gestational diabetes mellitus
OT  - Non-alcoholic fatty liver disease
OT  - Type 2 diabetes mellitus
EDAT- 2023/05/31 01:09
MHDA- 2023/08/14 06:41
CRDT- 2023/05/30 23:30
PHST- 2022/12/13 00:00 [received]
PHST- 2023/05/05 00:00 [accepted]
PHST- 2023/08/14 06:41 [medline]
PHST- 2023/05/31 01:09 [pubmed]
PHST- 2023/05/30 23:30 [entrez]
AID - 10.1007/s10654-023-01016-1 [pii]
AID - 10.1007/s10654-023-01016-1 [doi]
PST - ppublish
SO  - Eur J Epidemiol. 2023 Aug;38(8):901-911. doi: 10.1007/s10654-023-01016-1. Epub 
      2023 May 31.