Sex Influences Outcomes in Metabolic Dysfunction-associated Steatotic Liver Disease
Metabolic dysfunction-associated steatotic liver disease (MASLD), a prevalent condition affecting nearly 30% of the global population, presents unique risks for men and women. A massive study published in JAMA Network Open revealed significant disparities between the sexes for both liver-related and non-liver-related adverse outcomes.
The study, analyzing data on nearly 761,403 American adults with MASLD between 2007 and 2022, highlighted the higher risk of serious complications associated with this diagnosis depending on sex.
Men faced a more than twofold increased risk of hepatocellular carcinoma (HCC) compared to women. The risk of developing this aggressive liver cancer was 2.59 times higher.
Men also demonstrated an 11% increased risk of hepatic decompensation compared to women.
Conversely, women exhibited a 9% higher risk of both overall adverse liver events and cirrhosis compared to men. The Cleveland Clinic Lerner Research Institute previously indicated liver transplantation is the leading reason for transplanting women, highlighting severity of the condition’s progression in women.
However, the study noted men experienced higher rates for cardiovascular disease, chronic kidney disease, and non-gender specific cancers. This suggests that while MASLD itself may progress differently between genders, the risk for complications like heart disease and kidney issues is higher for men.
The scientists concluded that personalized care is crucial for managing MASLD.
They voiced the need for strategies that are tailored to biological sex to address the variability in outcomes between men and women.
Their research adds to a growing body of work highlighting the importance of considering sex differences in both understanding and treating disease.
What are the ethical considerations of tailoring MASLD treatment based on sex, especially given the argument that biological differences shouldn’t necessarily dictate treatment approaches?
Today we are joined by Dr. Emily Carter, a leading hepatologist, to discuss a groundbreaking study on metabolic dysfunction-associated steatotic liver disease, or MASLD. Dr. Carter, this study revealed startling sex-based differences in how MASLD progresses. Do you think these findings will change how doctors approach treatment for this increasingly common condition?
Some may argue that these differences are merely biological and shouldn’t influence treatment strategies. What would you say to those who hold that view?
