Acta Scientific Gastrointestinal Disorders (ISSN: 2582-1091)

Review ArticleVolume 4 Issue 9

Nonalcoholic Fatty Liver Disease: Approaches in the Development of Obstetric Complications in the Pregnant Women with Overweight

Lina Bahniy*, Svitlana Heryak and Nataliya Bahniy

Department of Obstetrics and Gynaecology № 2, I. Horbachevsky Ternopil National Medical University, Ukraine

*Corresponding Author: Lina Bahniy, Assistant, Department of Obstetrics and Gynaecology № 2, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.

Received: August 14, 2021; Published: August 23, 2021

Citation: Lina Bahniy. “Nonalcoholic Fatty Liver Disease: Approaches in the Development of Obstetric Complications in the Pregnant Women with Overweight". Acta Scientific Gastrointestinal Disorders 4.9 (2021): 43-50.


  Among the pathological conditions that are factors threatening the course of pregnancy, a special place is occupied by disorders of lipid metabolism. According to the WHO, 90% of overweight women develop early manifestations of hepatic steatosis at the age of 20 - 25, which leads to non-alcoholic steatohepatitis over the next five years of life. Therefore, overweight women are at risk for the development of obstetric and perinatal complications, in the genesis of which a significant role is given to metabolic disorders in the liver. The rationale for the planned study is the fact that the category of pregnant women with impaired lipid metabolism is progressively increasing.

A significant number of studies have been devoted to this issue in pregnant women in accordance with disorders of lipid metabolism, metabolic syndrome, diabetes mellitus and their complications associated with arterial hypertension, and so on. However, the authors did not pay attention to the role of the liver in lipid metabolism and the risk of developing steatosis and non-alcoholic steatohepatitis at a young age, which may worsen the course of pregnancy and childbirth. At the same time in the special literature there are no works, in which the pathogenetic mechanisms of functional disorders of the liver in women with impaired lipid metabolism and features of pregnancy and childbirth in this pathology have been studied.

Keywords: Nonalcoholic Fatty Liver Disease; Pregnancy; Disorders of Lipid Metabolism; Functional Condition of the Liver; Obstetric Complications


  1. Bredman SL., et al. “Mechanisms of NAFLD development and therapeutic strategies”. Nature Medicine 7 (2018): 908-922.
  2. Fazel Y., et al. “Epidemiology and natural history of non-alcoholic fatty liver disease”. Metabolism8 (2016): 1017-1025.
  3. European Association for the Study of the Liver (EASL); European Association for the Study of the Diabetes (EASD); European Association for the Study of the Obesity (EASO). EASL-EASD,EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease”. The Journal of Hepatology 64 (2016): 1388-1402.
  4. Shumacher JD and Guo GL. “Mechanustic Review of Drug-Induced Steatohepatitits”. Toxicology and Applied Pharmacology 1 (2015): 40-47.
  5. Rinella ME. “Nonalcoholic fatty liver disease: a systematic review”. The Journal of the American Medical Association 22 (2015): 2263-2273.
  6. Blachier M., et al. “The burden of liver disease in Europe: a review of available epidemiological data”. Journal of Hepatology 58 (2013): 593-608.
  7. Soresi M., et al. “Nonalcoholic fatty liver and metabolic syndrome in Italy: results from a multicentric study of the Italian Arteriosclerosis society”. Acta Diabetologica 50 (2013): 241-249.
  8. Yvashkyn VT., et al. “Rasprostranennost nealkoholnoi zhyrovoi bolezny pecheny u patsyentov ambulatorno- polyklynycheskoi praktyky v Rossyiskoi Federatsyy: rezultaty yssledovanyia DIREG 2”. Russian Journal of Gastroenterology, Hepatology, Coloproctology 6 (2016): 31-41.
  9. Poniedzialek-Czajkowska E., et al. “Intercellular adhesion molecule and endogenous NOS inhibitor: asymmetric dimethylarginine in pregnant women with gestational diabetes mellitus”. Journal of Diabetes Research (2016): 5.
  10. Stepanov YuM. “Rezultaty observatsiinoho perekhresnoho doslidzhennia PRELID 2 (2015-2016). Chastyna 1. Poshyrenist nealkoholnoi zhyrovoi khvoroby pechinky, kharakterystyka suputnoi patolohii, metabolichnoho syndromu ta yoho okremykh kryteriiv u patsiientiv, yaki zvertaiutsia do terapevtiv i hastroenterolohiv v Ukraini”. Gastroenterologìa1 (2019): 26-33.
  11. American College of Obstetricians and Gynecologists. Committee Opinion. Committee on Obstetric Practice: Obesity in Pregnancy 549 (2013).
  12. Grattagliano I., et al. “Utility of noninvasive methods for the character- ization of nonalcoholic liver steatosis in the family practice. The "VARES" Italian multicenter study”. Annals of Hepatology 1 (2013): 70-77.
  13. Younossi ZM., et al. “Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes”. Hepatology 1 (2016): 73-84.
  14. OYa Babak and KA Lapshyna. “Metabolichni zminy ta maloinvazyvna diahnostyka nealkoholnoho steatohepatytu u khvorykh na nealkoholnu zhyrovu khvorobu pechinky na tli hipertonichnoi khvoroby ta ozhyrinnia”. Aktual. probl. suchasn. med.: Visn. Ukr. med. stomat. akad.: naukovo-praktychnyi zhurnal 4.2 (2016): 57-60.
  15. De Lorenzo A., et al. “New obesity classification criteria as a tool for bariatric surgery indication”. World Journal of Gastroenterology2 (2016): 681-703.
  16. Rinella ME. “Nonalcoholic fatty liver disease: a systematic review”. The Journal of the American Medical Association22 (2015): 2263-2273.
  17. Angulo P., et al. “Simple noninvasive systems predict long-term outcomes of patients with nonalcoholic fatty liver disease”. Gastroenterology4 (2013): 782-789.
  18. Marit JR Endresen., et al. “Serum from preeclamptic women induces vascular cell adhesion molecule-1 expression on human endothelial cells in vitro: A possible role of increased circulating levels of free fatty acids”. American Journal of Obstetrics and Gynecology, Volume3 (1998): 665-670.
  19. Berardis S and Sokal E. “Pediatric non-alcoholic fatty liver disease: an increasing public health issue”. European Journal of Pediatrics2 (2014): 131-139.
  20. Angulo P., et al. “The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD”. Hepatology 45 (2007): 846-854.
  21. Caballero F., et al. “Enhanced free cholesterol, SREBP-2 and star expression in human nash”. Journal of Hepatology 50 (2009): 789-796.
  22. Savard C., et al. “Synergistic interaction of dietary cholesterol and dietary fat in inducing experimental steatohepatitis”. Hepatology 57 (2013): 81-92.
  23. Van Rooyen DM., et al. “Hepatic free cholesterol accumulates in obese, diabetic mice and causes nonalcoholic steatohepatitis”. Gastroenterology 141 (2011): 1393-1403.
  24. Wouters K., et al. “Dietary cholesterol, rather than liver steatosis, leads to hepatic inflammation in hyperlipidemic mouse models of nonalcoholic steatohepatitis”. Hepatology 48 (2008): 474-486.
  25. Simonen P., et al. “Cholesterol synthesis is increased and absorption decreased in non-alcoholic fatty liver disease independent of obesity”. Journal of Hepatology 54 (2011): 153-159.
  26. Walenbergh SM., et al. “Non-alcoholic steatohepatitis: The role of oxidized low-density lipoproteins”. Journal of Hepatology 58 (2013): 801-810.
  27. Tomita K., et al. “Free cholesterol accumulation in hepatic stellate cells: Mechanism of liver fibrosis aggravation in nonalcoholic steatohepatitis in mice”. Hepatology 59 (2014): 154-169.
  28. Chalasani N., et al. “The diagnosis and management of non-alcoholic fatty liver disease: Practice guideline by the American association for the study of liver diseases, American college of gastroenterology, and the American gastroenterological association”. Hepatology 55 (2012): 2005-2023.
  29. Titov VN. “Leptin i adiponectin v patogeneze metabolicheskogo sindroma”. Klinicheskaya Meditsina4 (2014): 20-29.
  30. Machado M., et al. “How adiponectin, leptin and ghrelin orchestrate together and correcale with severity of nonalcoholic fatty liver disease”. European Journal of Gastroenterology and Hepatology 24 (2012): 1166-1172.
  31. Ghadge AA., et al. “Adiponectin: a potential therapeutic target for metabolic syndrome”. Cytokine and Growth Factor Reviews 39 (2018): 151-158.
  32. Chen SJ., et al. “Relationships between Inflammation, Adiponectin, and Oxidative Stress in Metabolic Syndrome”. PLOS ONE9 (2012): 45693.
  33. Matsuzawa Y. “Establishment of a concept of visceral fat syndrome and discovery of adiponectin / Y. Matsuzawa”. Proceedings of the Japan Academy, Ser. B, Physical and Biological Sciences2 (2010): 131-141.
  34. Chen SJ., et al. “Relationships between Inflammation, Adiponectin, and Oxidative Stress in Metabolic Syndrome”. PLOS ONE9 (2012): 45693.
  35. Caimi G., et al. “Evaluation of nitric oxide metabolites in a group of subjects with metabоlic syndrome”. Diabetes and Metabolic Syndrome3 (2012): 132-135.
  36. Sheldon RD., et al. “Chronic NOS inhibition accelerates NAFLD progression in an obese rat model”. The American Journal of Physiology-Gastrointestinal and Liver Physiology308 (2015): G540-549.
  37. Ang C., et al. “Insulin-mediated vasorelaxation in pregnancy”. BJOG: An International Journal of Obstetrics and Gynaecology 10 (2001): 1088-1093.
  38. Leiva A., et al. “Nitric oxide is a central common metabolite in vascular dysfunction associated with diseases of human pregnancy”. Current Vascular Pharmacology 14 (2016): 237-259.
  39. Akturk M., et al. “Asymmetric dimethylarginine concentrations are elevated in women with gesta- tional diabetes”. Endocrine 38 (2010): 134-141.
  40. Sankaralingam S., et al. “Increased lectin-like oxidized low-density lipoprotein receptor-1 expression in the maternal vasculature of women with preeclampsia: role for peroxynitrite”. Hypertension 53 (2009): 270-277.
  41. Anti-Aging Genes Improve Appetite Regulation and Reverse Cell Senescence and Apoptosis in Global Populations”. Advances in Aging Research 5 (2016): 9-26.
  42. Single Gene Inactivation with Implications to Diabetes and Multiple Organ Dysfunction Syndrome”. Journal of Clinical Epigenetics3 (2017): 24.
  43. Nutrition Therapy Regulates Caffeine Metabolism with Relevance to NAFLD and Induction of Type 3 Diabetes”. Journal of Diabetes and Metabolic Disorders 4 (2017): 019.
  44. Sirtuin A. “Diagnostic Protein Marker and its Relevance to Chronic Disease and Therapeutic Drug Interventions”. EC Pharmacology and Toxicology4 (2018): 209-215.

Copyright: © Lina Bahniy. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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