GGT

This study examined the relationship between pregravid liver enzyme levels and the risk of gestational diabetes mellitus (GDM) in a nested case-control design. Among 256 GDM cases and 512 matched controls, being in the highest quartile of γ-glutamyl transferase (GGT) levels was associated with a twofold increased risk of GDM (odds ratio 1.97, 95% CI: 1.14–3.42) after adjusting for race/ethnicity, BMI, family history of diabetes, and alcohol use. This association was attenuated after further adjustment for insulin resistance (HOMA-IR), fasting status, and gestational weight gain, and it was significant only among women in the highest tertile of HOMA-IR. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were not associated with GDM risk. The study concludes that pregravid elevated GGT levels, a marker of liver fat accumulation, may predict future GDM risk and could identify women at increased risk years before pregnancy.