# Fatty liver index in early pregnancy predicts the risk of gestational diabetes mellitus

## TL;DR

The fatty liver index in early pregnancy can predict the risk of developing gestational diabetes mellitus.

## Contribution

The fatty liver index (FLI) is shown to be an independent predictor of gestational diabetes mellitus (GDM) risk in early pregnancy.

## Key findings

- Women in the highest FLI tertile had 1.881 times higher risk of GDM compared to the lowest tertile.
- FLI cut-off of 5.108 predicted GDM risk with 77.7% sensitivity.
- FLI was significantly higher in GDM group compared to normal glucose tolerance group.

## Abstract

To examine the ability of the fatty liver index (FLI) in early pregnancy to predict the risk of Gestational Diabetes Mellitus (GDM).

A total of 1,004 women underwent metabolism characterization at weeks 8–12 of gestation and a 75 g oral glucose tolerance test (OGTT) at weeks 24–28 of gestation. The participants were divided into the normal glucose tolerance (NGT, n = 816) and GDM (n = 188) groups according to the OGTT results. Pregnant women were divided into three tertiles according to their FLI scores in early pregnancy. Multivariable regression analysis was performed to estimate the independent relationship between FLI and GDM.

The FLI values of the GDM and NGT groups were 8.47 (5.26, 13.41) and 6.10 (3.90, 10.41), the differences were significant (P < 0.001). The FLI values of the T1–T3 groups were 3.49 (2.74, 4.07), 6.43 (5.58, 7.51), and 14.46 (10.96, 21.58), respectively. The differences in homeostasis model assessment of insulin resistance (HOMA–IR), TyG, TG/HDL-C, LDL-C/HDL-C, TC/HDL-C, and ALT/AST between the T1–T3 groups were significant and gradually increased (P < 0.001). The risk of GDM in pregnant women in the highest FLI tertile was 1.881 times greater than that in the lowest FLI tertile(OR = 1.881, 95% CI: 1.049–3.374, P = 0.034).The cut-off point of FLI for predicting the risk of GDM was 5.108. Compared with other three indicators, FLI has better sensitivity (77.7%), but the specificity was slightly lower (41.1%).

The early pregnancy FLI is an independent risk factor for GDM. A high FLI is predictive of GDM risk.