Steatometry as a screening method for metabolic-associated steatotic liver disease during pregnancy
DOI:
https://doi.org/10.15574/PP.2025.4(104).2531Keywords:
metabolic-associated steatotic liver disease, steatometry, ultrasound examination, liver steatosis, diagnostics, pregnancy, obstetricsAbstract
Aim - to evaluate the possibility of ultrasound steatometry in the detection and staging of hepatic steatosis in pregnant women with risk factors for metabolic-associated steatosis of the liver (MASDL) to optimize the early diagnosis of this nosology in obstetric practice.
Materials and methods. The work used ultrasound examination and liver steatometry on the Samsung Medison V7 ultrasound device in 76 pregnant women, who were divided into groups: I (main) - 46 pregnant women with a burdened somatic history: obesity, type 2 diabetes, hypertension, gestational diabetes, dyslipidemia, and II (control) - 30 healthy pregnant women. New methods of quantitative ultrasound assessment of liver steatosis (QUS) based on Samsung QUS technology were used, where visualization with tissue attenuation - tissue attenuation indices (TAI) and visualization with tissue scattering distribution - tissue scattering index (TSI), percentage of fat fraction in the liver with subsequent statistical processing of the results obtained
Results. It was determined that MASDL occurs in pregnant women with obesity, type 2 diabetes, hypertension, gestational diabetes, and dyslipidemia. Therefore, to reduce the occurrence of obstetric and prenatal complications associated with this pathology, steatometry is recommended in the early stages of pregnancy to identify a high-risk group for the development of MASDL, and this is the goal of our further research.
Conclusions. In pregnant women with a complicated somatic history: obesity, type 2 diabetes, hypertension, gestational diabetes, dyslipidemia, it is advisable to perform liver ultrasound with steatometry in the early stages of pregnancy, which will allow for timely detection of MASDL and determine rational tactics for managing pregnancy, childbirth and the postpartum period, thereby reducing obstetric and perinatal complications.
The study was conducted in accordance with the opinion of the Ethics Committee of the Bogomolets National Medical University, in accordance with the Declaration of Helsinki. Informed consent to participate was obtained from all pregnant women.
The authors declare no conflict of interest.
References
Bahnii LV, Heriak SM, Bahnii NI. (2020). Patohenetychni aspekty formuvannia akusherskykh uskladnen u vahitnykh iz nealkoholnoiu zhyrovoiu khvoroboiu pechinky pry nadlyshkovii masi tila. Zbirnyk naukovykh prats asotsiatsii akusher-hinekolohiv Ukrainy «Aktualni pytannia pediatrii, akusherstva ta hinekolohii. 2: 37-44. https://doi.org/10.35278/2664-0767.1(47).2021.242659
Ballestri S, Zona S, Targher G, Romagnoli D, Baldelli E, Nascimbeni F et al. (2016). Nonalcoholic fatty liver disease is associated with an almost twofold increased risk of incident type 2 diabetes and metabolic syndrome. Evidence from a systematic review and meta-analysis. J Gastroenterol Hepatol. 31: 936-944. https://doi.org/10.1111/jgh.13264; PMid:26667191
Chakravarthy MV, Siddiqui MS, Forsgren MF, Sanyal AJ. (2020). Harnessing muscle-liver crosstalk to treat nonalcoholic steatohepatitis. Front Endocrinol. 11: 592373. https://doi.org/10.3389/fendo.2020.592373; PMid:33424768 PMCid:PMC7786290
De Lorenzo А, Soldati L, Sarlo F, Calvani M. (2016). New obesity classification criteria as a tool for bariatric surgery indication. World J. Gastroenterol. 22(2): 681-703. https://doi.org/10.3748/wjg.v22.i2.681; PMid:26811617 PMCid:PMC4716069
Dowman JK, Tomlinson JW, Newsome PN. (2010). Pathogenesis of non-alcoholic fatty liver disease. QJM. 103: 71-83. Epub 2009 Nov 13. https://doi.org/10.1093/qjmed/hcp158; PMid:19914930 PMCid:PMC2810391
Dynnik OB, Fedusenko AA, Kobyliak NN y dr. (2016). 6 yzmerenyi ultrazvukovoi dyahnostyky dyffuznykh zabolevanyi pecheny, yly multyparametrycheskyi ultrazvuk. Promeneva diahnostyka, promeneva terapiia 3-4: 69-84.
EASL, EASD, EASO. (2024, Sep). EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD) European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD). Journal of Hepatology. 81: 492-542. https://doi.org/10.1016/j.jhep.2024.04.031; PMid:38851997
European Association for the Study of the Liver et al. (2024). EASL-EASD-EASO clinical practice guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). Obes Facts. 17(4): 374-444. https://doi.org/10.1159/000539371; PMid:38852583 PMCid:PMC11299976
European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). (2016). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 64: 1388-1402. https://doi.org/10.1016/j.jhep.2015.11.004; PMid:27062661 PMCid:PMC9904363
Fazel Y, Koenig AB, Sayiner M, Goodman ZD, Younossi ZM. (2016). Epidemiology and natural history of non-alcoholic fatty liver disease. Metabolism. 65(8): 1017-1025. Epub 2016 Jan 29. https://doi.org/10.1016/j.metabol.2016.01.012; PMid:26997539
Gotteland M, Magne F. (2017). Alterations in human milk leptin and insulin are associated with early changes in the infant intestinal microbiome. Am J Clin Nutr. 105(1): 234. https://doi.org/10.3945/ajcn.116.140129; PMid:28049664 PMCid:PMC5183729
Gross A, Lange M, Rosenbluth E, Carroll C, Sperling R, Juliano C et al. (2023). Evaluation of 2-year outcomes in infants born to mothers with and without NAFLD in pregnancy. Eur J Pediatr. 182(8): 3765-3774. Epub 2023 Jun 13. https://doi.org/10.1007/s00431-023-05044-7; PMid:37310499 PMCid:PMC12166767
Hagstrom H, Vessby J, Ekstedt M, Shang Y. (2024). 99% of patients with NAFLD meet MASLD criteria and natural history is therefore identical. J Hepatol. 80(2): e76-e77. Epub 2023 Sep 9. https://doi.org/10.1016/j.jhep.2023.08.026; PMid:37678723
Jeon SK, Lee JM, Joo I, Park SJ. (2021, Jul). Quantitative Ultrasound Radiofrequency Data Analysis for the Assessment of Hepatic Steatosis in Nonalcoholic Fatty Liver Disease Using Magnetic Resonance Imaging Proton Density Fat Fraction as the Reference Standard. Korean J Radiol. 22(7): 1077-1086. Epub 2021 Mar 9. https://doi.org/10.3348/kjr.2020.1262; PMid:33739636 PMCid:PMC8236371
Kahn CR, Wang G, Lee KY. (2019). Altered adipose tissue and adipocyte function in the pathogenesis of metabolic syndrome. J Clin Invest. 129: 3990-4000. https://doi.org/10.1172/JCI129187; PMid:31573548 PMCid:PMC6763230
Kanwal F, Shubrook JH, Younossi Z, Natarajan Y, Bugianesi E, Rinella ME et al. (2021, Sep). Preparing for the NASH epidemic: a call to action. Gastroenterology. 161(3): 1030-1042.е8. Epub 2021 Jul 26. https://doi.org/10.1053/j.gastro.2021.04.074; PMid:34416976
Lao TT. (2020, Oct). Implications of abnormal liver function in pregnancy and non-alcoholic fatty liver disease. Best Pract Res Clin Obstet Gynaecol. 68: 2-11. Epub 2020 Mar 7. https://doi.org/10.1016/j.bpobgyn.2020.02.011; PMid:32312689
Lee SS, Park SH, Kim HJ, Kim SY, Kim M-Y, Kim DY et al. (2010). Non invasive assessment of hepatic steatosis: Prospective comparison of the accuracy of imaging examinations. Journal of Hepatology. 52(4): 579-585. https://doi.org/10.1016/j.jhep.2010.01.008; PMid:20185194
Mintser AP. (2018). Statisticheskie metodyi issledovaniya v klinicheskoy meditsine. Prakticheskaya meditsina. 3: 41-45.
Park J, Lee JM, Lee G, Jeon SK, Joo I. (2022, Jan). Quantitative Evaluation of Hepatic Steatosis Using Advanced Imaging Techniques: Focusing on New Quantitative Ultrasound Techniques. Korean J Radiol. 23(1): 13-29. https://doi.org/10.3348/kjr.2021.0112; PMid:34983091 PMCid:PMC8743150
Рrуlutska AB, Solovyova GA, Martynova LI, Kisilenko ОL, Tsema TА, Govsіeіev DО. (2025). Obstetric aspects of metabolically associated steatotic liver disease. Ukrainian Journal of Perinatology and Pediatrics. 2(102): 87-96. https://doi.org/10.15574/PP.2025.2(102).8796
Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, Abdelmalek MF, Caldwell S, Barb D et al. (2023, May 1). AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 77(5): 1797-1835. Epub 2023 Mar 17. https://doi.org/10.1097/HEP.0000000000000323; PMid:36727674 PMCid:PMC10735173
Sanders FWB, Acharjee A, Walker C, Marney L, Roberts LD, Imamura F et al. (2018). Hepatic steatosis risk is partly driven by increased de novo lipogenesis following carbohydrate consumption. Genome Biol. 19: 79. https://doi.org/10.1186/s13059-018-1439-8; PMid:29925420 PMCid:PMC6009819
Sarkar M, Kushner T. (2025). Metabolic dysfunction-associated steatotic liver disease and pregnancy. J Clin Invest. 135(10): e186426. https://doi.org/10.1172/JCI186426; PMid:40371643 PMCid:PMC12077888
Sasso M, Beaugrand M, de Ledinghen V et al. (2010, Nov). Controlled attenuation parameter (CAP): a novel VCTE™ guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: preliminary study and validation in a cohort of patients with chron ic liver disease from various causes. Ultrasound Med Biol. 36(11): 1825-35. https://doi.org/10.1016/j.ultrasmedbio.2010.07.005; PMid:20870345
Stoikevych M, Konenko I, Nedzvetskaya N. (2021). Age features of liver status in patients with chronic inflammatory bowel diseases according to steatometry and shear wave elastography. Gastroenterology. 52(2): 77-82. https://doi.org/10.22141/2308-2097.52.2.2018.132612
Terrault NA, Williamson C. (2022, Jul). Pregnancy-Associated Liver Diseases. Gastroenterology. 163(1): 97-117.e1. Epub 2022 Mar 8. https://doi.org/10.1053/j.gastro.2022.01.060; PMid:35276220
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