Sex-specific prevalence of fatty liver disease and associated metabolic factors in Wuhan, south central China

Abstract

Background This study aimed to investigate the sexspecific prevalence and metabolic risk factors of fatty liver disease (FLD), and to predict the prevalence of steatohepatitis with liver fibrosis in Wuhan, south central China.Methods A cross-sectional study was conducted among 25 032 participants who underwent health checkups from 2010 to 2011 in Zhongnan hospital. ResultsThe prevalence of FLD was higher among men than among women (31.8 vs. 12.9%, P < 0.0001). However, it increased markedly with age among women, and in the agegroups above 60 years, the prevalence was similar between men and women (26.4 vs. 27.6%, P > 0.05). FLD was associated with obesity, increased levels of total cholesterol, triglycerides (TG), low-density lipoproteins, serum uric acid, aspartate aminotransferase, alanine aminotransferase, and fasting blood sugar, an aspartate aminotransferase/alanine aminotransferase ratio of less than 1, and a decreased level of high-density lipoprotein in both sexes. Multiple regression analyses showed that obesity, elevated levels of fasting blood sugar, TG, total cholesterol, and alanine aminotransferase, an aspartate aminotransferase/alanine aminotransferase ratio of less than 1, serum uric acid levels, and decreased high-density lipoprotein levels were related to FLD in men, whereas age played a more prominent role in women.The prevalence of steatohepatitis with advanced fibrosis, estimated using the BMI, age, ALT, and TG index (BAAT index), was 2.5% in men and 1.4% in women; more women with FLD had a BAAT score of 3 or higher compared with men (9.0 vs. 6.6%).Conclusion The prevalence of FLD in China is high among men and elderly women and is mainly related to various metabolic parameters. The prevalence of steatohepatitis with advanced fibrosis is considerably high among individuals with FLD. Eur J Gastroenterol Hepatol

NAFLD as a Sexual Dimorphic Disease: Role of Gender and Reproductive Status in the Development and Progression of Nonalcoholic Fatty Liver Disease and Inherent Cardiovascular Risk

“…Accordingly, the prevalence of NAFLD in women rises after the age of 50 years, peaks at 60–69 years, and declines after 70 years [47, 54, 56]. As a result of this, after the fifth decade, postmenopausal women compared to men of the same age have a similar [46, 49, 60, 65] or even higher [47, 51] prevalence of NAFLD. In agreement with these findings, a multicenter study from northern Italy found that men with NAFLD were approximately 10 years younger than women with this condition [79], a finding compatible with the hypothesis that premenopausal women are “protected” from developing NAFLD.…”

“…Some studies have shown an independent, positive association between NAFLD and increasing age in both sexes [46, 50–53, 70, 74] or in females only [65], while others reported an inverse association [41, 48, 62, 63]. At variance, other studies have shown that sex differences in the prevalence of NAFLD were mostly accounted for by metabolic factors [36, 37, 55, 56, 60, 63, 64].…”

“…At variance, other studies have shown that sex differences in the prevalence of NAFLD were mostly accounted for by metabolic factors [36, 37, 55, 56, 60, 63, 64]. Finally, some studies failed to investigate the role of gender given that a separate multivariate analysis according to sex was not performed [34, 49, 54, 56, 61, 65, 68, 70, 71]. …”

Epidemiological modifiers of non-alcoholic fatty liver disease: Focus on high-risk groups

“…Middle-aged and elderly individuals have a higher prevalence of fibrosing NASH. 35,36 Most studies, 20,32,[37][38][39] except one, 40 have reported that NASH is histologically more severe in women than in men.…”

“…16,18,19 Accordingly, after the 5th decade, the prevalence of NAFLD is similar in both sexes or possibly lower in men. 16,20 Most, though not all, studies have shown that advancing age and male sex affect the risk of NAFLD, independently of coexisting MetS features. [21][22][23][24][25][26] Other studies, although confirming that men are at higher risk of NAFLD, have shown an inverse association between NAFLD and age.…”