NAFLD in Women: Unique Pathways, Biomarkers, and Therapeutic Opportunities
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Purpose of review
In this review article, we evaluate sex differences in the natural history of NAFLD and highlight distinct risk profiles of women with NAFLD, as well as unique treatment considerations and research gaps.
Summary of Findings
Reproductive factors, such as menopausal status, should be considered when evaluating NAFLD risk in women, as well as additional reproductive risk factors such as age at menarche, presence of polycystic ovary syndrome, and gestational diabetes. Women do appear to have lower risk for hepatocellular carcinoma from NASH, as well as lower mortality from NASH cirrhosis than men, although among women, NASH is now the leading indication for liver transplant. Data on sex differences in biomarker development and clinical trials are lacking, and researchers should be encouraged to evaluate biomarker performance by sex, and specifically report clinical trial endpoints in women.
KeywordsNonalcoholic fatty liver Hormones Sex differences Women
Compliance with Ethical Standards
Conflict of Interest
Liyun Yuan and Ani Kardashian each declare no potential conflicts of interest.
Monika Sarkar is a site PI for a pharmaceutical sponsored drug trial in women with NAFLD and PCOS for Zydus Pharmaceuticals.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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