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

Objective To examine the ability of the fatty liver index (FLI) in early pregnancy to predict the risk of Gestational Diabetes Mellitus (GDM). Methods 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. Results 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%). Conclusion The early pregnancy FLI is an independent risk factor for GDM. A high FLI is predictive of GDM risk.