P17.02: Hepatic steatosis: a prenatal process?

Abstract

The intrahepatic lipid content (IHLC) is increased in the neonatal offspring of obese women with gestational diabetes. However, it is still unknown, at which time point and to what extend the human liver stores lipids. The aim of this study was to evaluate if hepatic steatosis is already present in utero and if the presence of hepatic steatosis is associated with maternal body composition. We prospectively investigated the livers of 127 fetuses (gestational week 19-38) with mDixon multiecho sequences to assess the IHLC in both liver lobes. A proton density fat fraction (PDFF) of 0-3% was considered as no steatosis, a PDFF between 3.1 and 5% as mild steatosis, between 5.1 and 6.9% as moderate steatosis and above 6,9% as severe steatosis. Maternal body composition was evaluated; a pregestational BMI up to 25kg/m2 was considered to be normal, 25.1-30 kg/m2 to be overweighted and ≥30 kg/m2 to be obese. A mild steatosis was found in 27/127 (21.3%) fetuses; the mean maternal BMI of these fetuses was 27.5 +±3.1kg/m2. In two fetuses (GW 34+0 and 33+5) we found a moderate steatosis; the maternal body composition was obese in both cases (BMI 30.4 and 30.9 kg/m2). Maternal body composition is statistically significant (0.017) associated with the presence of steatosis (normal n=50, 12%; overweight n=49, 26,5%; obesity n=28, 39,3%). Hepatic steatosis is already present in utero and associated with maternal body composition. However, proceeding the clinical study to increase the study population is necessary to prove our preliminary results.