Sex differences in metabolic dysfunction-associated steatotic liver disease: a narrative review
Received: Apr 20, 2024; Revised: Apr 22, 2024; Accepted: Apr 22, 2024
Published Online: Apr 30, 2024
Abstract
Understanding the effects of sex and sex differences on liver health and disease is crucial to individualized healthcare and informed decision-making for patients with liver disease. The impact of sex on liver disease varies according to its etiology. Women have a lower prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) than men. However, women who are in the postmenopausal stage are at higher risk for advanced liver fibrosis because of hormonal influences. Sex differences affect the pathogenesis of MASLD, which comprises a complex process involving several factors such as hormones, obesity, and the gut microbiome. Furthermore, sex-related differences in the development of MASLD-related hepatocellular carcinoma (HCC) have been observed. Given that MASLD exhibits a sex-differentiated characteristics, an individualized management approach based on scientific evidence is necessary. However, research in this area has been lacking. This article reviews the current understanding of sex differences in MASLD.