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Review
. 2023 Mar;11(2):218-227.
doi: 10.1002/ueg2.12370. Epub 2023 Mar 3.

Influence of sex in alcohol-related liver disease: Pre-clinical and clinical settings

Debora Bizzaro  1 , Chiara Becchetti  2 , Silvia Trapani  3 , Bruna Lavezzo  4 , Alberto Zanetto  1 , Francesca D'Arcangelo  1 , Manuela Merli  5 , Lucia Lapenna  5 , Federica Invernizzi  6 , Gloria Taliani  7 , Patrizia Burra  1 ; AISF Special Interest Group on Gender in Hepatology
Affiliations
Review

Influence of sex in alcohol-related liver disease: Pre-clinical and clinical settings

Debora Bizzaro et al. United European Gastroenterol J. 2023 Mar.

Abstract

Alcohol-related liver disease (ArLD) is a major cause of chronic liver disease globally. Traditionally, ArLD was mostly a concern in men rather than in women; however, such a sex gap is rapidly narrowing due to increasing chronic alcohol consumption among women. Female sex is more vulnerable to the harmful effects of alcohol with a higher risk of progression to cirrhosis and development of associated complications. The relative risk of cirrhosis and liver-related mortality is significantly higher in women than in men. Our review endeavors to summarize the current knowledge on sex differences in alcohol metabolism, pathogenesis of ArLD, disease progression, indication for liver transplant and pharmacological treatments of ArLD, and provide evidence in support of a sex-specific management of these patients.

Keywords: alcohol; cirrhosis; gender; portal hypertension; sex.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Liver pathways involved in alcohol metabolism. ADH, alcohol dehydrogenase; ALDH, aldehyde dehydrogenase; EtG, ethyl glucuronide; EtS, ethyl sulfate; FAEE, fatty acid ethyl esters; PEth, phosphatidylethanol; ROS, reactive oxygen species; VLDL, very‐low‐density lipoprotein.
FIGURE 2
FIGURE 2
Role of sex differences in alcohol metabolism and its harmful effect. ADH, alcohol dehydrogenase; TBW, total body water.
See this image and copyright information in PMC

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