Evidence mapPaperPMID 42311541Full record

SynthesisJournal of the ASEAN Federation of Endocrine Societies2026

Liver Enzyme Biomarkers Before or in Early Pregnancy as Predictors for Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis.

Samuel Pratama, Rizka Dwi Aulia, Indi Jazilah, Brigitta Cindy Lauren

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Journal of the ASEAN Federation of Endocrine Societies, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Samuel PratamaDepartment of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Rizka Dwi AuliaDepartment of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Indi JazilahDepartment of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Brigitta Cindy LaurenFaculty of Medicine, University of Indonesia, Jakarta, Indonesia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Liver enzymes may reflect early metabolic disturbances and insulin resistance preceding gestational diabetes mellitus (GDM). This systematic review and meta-analysis evaluated whether liver enzyme biomarkers measured before or in early pregnancy are associated with subsequent development of GDM. Methodology: PubMed, Cochrane, EBSCOHost, and SCOPUS databases were searched through May 2025 for observational studies or trials assessing pre- or early pregnancy liver enzymes in relation to GDM development. Pooled mean differences (MD) and odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model. Risk of bias was assessed using RoB 2.0 and ROBINS-E; certainty of evidence was evaluated using GRADE. Results: Twenty-seven studies were included in the analyses. GDM was associated with higher AST (MD 0.97 U/L; OR 1.42), ALT (MD 2.38 U/L; OR 1.69), GGT (MD 3.77 U/L; OR 2.57), and hepatic steatosis index (HSI) (MD 2.82; OR 2.19). ALP showed no significant mean difference but an elevated GDM risk (OR 1.47). Substantial heterogeneity was observed with very low certainty of evidence across outcomes. Conclusion: Elevated liver enzymes, especially GGT and HSI, are associated with increased GDM risk at a population level. However, high heterogeneity and very low certainty of evidence limit current clinical applicability, warranting further prospective validation.

Indexed as

Diabetes, GestationalLiverAlanine TransaminaseAlkaline PhosphataseAspartate AminotransferasesBiomarkersFemalegamma-GlutamyltransferaseHumansPregnancyAlanine TransaminaseAlkaline PhosphataseAspartate AminotransferasesBiomarkersgamma-Glutamyltransferasegestational diabetes mellitusliver enzymesmeta-analysisodds ratiopregnancy

Identifiers

PMID42311541
PMCPMC13269346

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.