Clinical Impact of Sexual Dimorphism in Non-alcoholic Fatty Liver Disease (NAFLD) and Non-alcoholic Steatohepatitis (NASH)

Patrizia Burra; Debora Bizzaro; Anna Gonta; Sarah Shalaby; Martina Gambato; Maria Cristina Morelli; Silvia Trapani; Annarosa Floreani; Fabio Marra; Maurizia Rossana Brunetto; Gloria Taliani; Erica Villa


Liver International. 2021;41(8):1713-173. 

In This Article

Conclusions and Future Directions

Although sex differences exist in the prevalence, risk factors, fibrosis and clinical outcomes of NAFLD, our understanding of sex differences in NAFLD has remained significantly more limited so far, compared to other areas of medicine. To fill this gap, more accurate epidemiological and pathophysiological data obtained from larger cohort studies are needed.

The future direction in the management of NAFLD/NASH patients – regardless the gender – should be the early identification of NAFLD to prevent progression to fibrosis and NASH. Moreover, detailed program of education, especially in the young population at risk of develop overweight, obesity and liver steatosis should be developed.

Therefore, an appropriate consideration of sex, age, hormonal status and sociocultural background will lead to a better understanding of sex differences in NAFLD risk, and will aid in personalization of therapies. In addition, it is mandatory to stimulate the design of clinical studies aimed at sex and gender differences in NASH therapy to better characterize sex-specific therapeutic targets and responses.