Sexual Dimorphism in Decompensated Non Ethanol-related Chronic Liver Disease: A Retrospective Cohort Study
Introduction: Women exhibit a distinct natural history of chronic liver disease compared to men, particularly regarding progression and outcomes. Although liver disease prevalence is generally higher in men, the incidence of non ethanol-related liver disease is increasing among females. Metaboli...
Main Authors: | , , , , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2024-01-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://www.jcdr.net/articles/PDF/18911/64558_CE[Ra1]_F(SS)_QC(KK_RDW_IS)_PF1(VD_DK_OM)_PFA_NC(VD_KM)_PN(KM).pdf |
Summary: | Introduction: Women exhibit a distinct natural history of
chronic liver disease compared to men, particularly regarding
progression and outcomes. Although liver disease prevalence
is generally higher in men, the incidence of non ethanol-related
liver disease is increasing among females. Metabolic syndromes
and their consequences are less recognised in the female
population until they develop end-stage cirrhosis. Limited
studies have explored the differences between male and female
cirrhosis. The present study aimed to address the knowledge
gap in female Decompensated Chronic Liver Disease (DCLD).
Aim: To identify the differences in presentation and outcomes
between females and males with non ethanol-related cirrhosis.
Materials and Methods: The present retrospective cohort study
was conducted in the Department of Medical Gastroenterology
and Hepatology,Tirunelveli Medical College, Tirunelveli, Tamil
Nadu, India, involving 27 males and 33 females with non
ethanol-related decompensated cirrhosis. A comparison
was made between the aetiologies, presenting symptoms,
complications, laboratory values, Model for End-stage Liver
Disease (MELD) score, and in-hospital mortality during the first
decompensation. Data analysis was performed using Statistical
Packages for Social Sciences (SPSS) version 24.0 Quantitative
variables were expressed as mean and Standard Deviation,
while qualitative variables were expressed as frequency and
percentage. The association between categorical variables
was analysed using the Chi-square test, and the comparison
of continuous variables between the two groups was analysed
using independent sample t-test. A p-value of <0.05 was
considered statistically significant.
Results: The mean age of decompensation was 56.5 years for
men and 50.9 years for women. The most common aetiology
in men was Non Alcoholic Fatty Liver Disease (NAFLD) (63%),
while in females, it was NAFLD (45%) and cryptogenic cirrhosis
(45%) (p=0.020). Diabetes Mellitus (DM) was more prevalent in
males (55.6% versus 33.3%). Variceal bleed was more common
in females (66.7% versus 48.1%). Jaundice was more frequently
observed in males (44.4% versus 21.2%) (p=0.05). Ascites was
more prominent in males (70.4% versus 45.5%) (p=0.05). Hepatic
Encephalopathy (HE) was more prevalent in males (22.2% versus
15.2%). Females had a lower MELD scores compared to males
(12.4±6.1 versus 15.2±6.4). Mortality was higher in males (22.2%
versus 12.1%).
Conclusion: Women with Decompensated Chronic Liver Disease
tend to decompensate at a younger age compared to males
and have a higher risk of Upper Gastrointestinal (UGI) bleeding.
NAFLD was the most common aetiology in both groups. Ascites
and HE were more commonly observed in men. Females had
lower MELD scores, resulting in a longer waiting period on the
transplant list compared to males. Mortality was higher in males. |
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ISSN: | 2249-782X 0973-709X |