Prior Gestational Diabetes Is Associated with Metabolic Dysfunction–Associated Steatotic Liver Disease Independent of Adiposity: A Transient Elastography Study

Introduction and Objective: Gestational diabetes (GDM) and metabolic dysfunction-associated steatotic liver disease (MASLD) are prevalent and confer increased cardiometabolic risk. We evaluated the association between prior GDM and MASLD. Methods: Cross-sectional study of women ≥18 years with and without prior GDM. All underwent vibration-controlled transient elastography (CAP >288 dB/m), anthropometric and metabolic testing. Results: Among 162 women (83 prior GDM, 79 non-GDM), MASLD prevalence was 37% overall and higher in the GDM group (45.7% vs 27.8%, p=0.01). Women with prior GDM were older, had higher BMI, and higher prevalence of type 2 diabetes. In multivariable logistic regression, body fat percentage (BFP) independently predicted MASLD (OR 1.13, 95% CI 1.06-1.20, p<0.001). When BFP was excluded, prior GDM remained independently associated with MASLD (OR 2.02, 95% CI 1.01-4.06, p=0.04). Conclusion: Prior GDM is associated with a higher prevalence of MASLD independent of adiposity. Transient elastography reveals a substantial MASLD burden in this high-risk population. Disclosure: G. Rios-Ortega: None. A. Sánchez-García: None. R. Rodriguez-Gutierrez: None. F.J. Lavalle-Gonzalez: Consultant; Current; Lilly, Novo Nordisk, Sanofi, AstraZeneca, Boehringer Ingelheim International GmbH. M.V. Villagómez Estrada: None. I. Angulo Gallardo: None. J.A. Villarreal: None. A. Guzman-Lopez: None. L.G. Mancillas Adame: None.