Evangelista Sagnelli1, Tommaso Stroffolini2, Caterina Sagnelli3, Mario Pirisi4, Sergio Babudieri5, Guido Colloredo6, Maurizio Russello7, Nicola Coppola3, Giovanni Battista Gaeta8, Bruno Cacopardo9, Massimo De Luca10, Piero Luigi Almasio11. 1. Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy. evangelista.sagnelli@unicampania.it. 2. Department of Tropical and Infectious Diseases, Policlinico Umberto Primo, Rome, Italy. 3. Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy. 4. Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy. 5. Clinic of Infectious Diseases, University of Sassari, Sassari, Italy. 6. Department of Internal Medicine, San Pietro Hospital, Bergamo, Ponte San Pietro, Italy. 7. Liver Unit, Hospital ''G. Garibaldi" Catania, Catania, Italy. 8. Infectious Diseases, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy. 9. Infectious Diseases, University of Catania, Catania, Italy. 10. Liver Unit, Department of Transplantation, Division of Hepatology, Cardarelli Hospital, Naples, Italy. 11. Gastroenterology & Hepatology Unit, Di.Bi.MI.S. University of Palermo, Palermo, Italy.
Abstract
BACKGROUND: Gender differences in chronic liver disease (CLD) have been partially investigated. To extend the present knowledge, we evaluated 12,263 patients with CLD enrolled in two national surveys (9997 in 2001 and 2557 in 2014). METHODS: The two surveys prospectively recruited patients aged ≥ 18 referring to Italian liver units throughout the country using a similar clinical approach and analytical methods. RESULTS: The overall male to female ratio (M/F) was 1.4 (7138/5124). Compared with females, males were significantly more likely to be younger (52.9 vs. 58.7 yrs.), with HBV infection alone (13.2% vs. 9.2%) and with alcoholic liver disease alone (11.4% vs. 6.9%), but less likely to show HCV infection alone (48.0% vs. 67.9%). A male preponderance was observed in HBV-related cases (1.99) and in alcoholic-related cases (2.3), a preponderance observed both in the 2001 and in 2014 cases. In HCV-related cases, however, females predominated in 2001 (M/F 0.9) and males in 2014 (M/F 1.5).The rate of cirrhosis in alcohol-related etiology was close to 36% in both genders, a finding much higher than that observed for both sexes in HBV and HCV etiologies.Both males and females enrolled in 2014 were older (p < 0.001) and with a higher rate of cirrhosis and/or HCC (p < 0.001) than those investigated in 2001. There was a remarkable increase over time in the proportion of male abstainers (36.7% in 2001 and 64.3% in 2014). CONCLUSION: This study highlights important inter- and intra-gender differences in the characteristics and etiological factors of patients with CLD in Italy.
BACKGROUND: Gender differences in chronic liver disease (CLD) have been partially investigated. To extend the present knowledge, we evaluated 12,263 patients with CLD enrolled in two national surveys (9997 in 2001 and 2557 in 2014). METHODS: The two surveys prospectively recruited patients aged ≥ 18 referring to Italian liver units throughout the country using a similar clinical approach and analytical methods. RESULTS: The overall male to female ratio (M/F) was 1.4 (7138/5124). Compared with females, males were significantly more likely to be younger (52.9 vs. 58.7 yrs.), with HBV infection alone (13.2% vs. 9.2%) and with alcoholic liver disease alone (11.4% vs. 6.9%), but less likely to show HCV infection alone (48.0% vs. 67.9%). A male preponderance was observed in HBV-related cases (1.99) and in alcoholic-related cases (2.3), a preponderance observed both in the 2001 and in 2014 cases. In HCV-related cases, however, females predominated in 2001 (M/F 0.9) and males in 2014 (M/F 1.5).The rate of cirrhosis in alcohol-related etiology was close to 36% in both genders, a finding much higher than that observed for both sexes in HBV and HCV etiologies.Both males and females enrolled in 2014 were older (p < 0.001) and with a higher rate of cirrhosis and/or HCC (p < 0.001) than those investigated in 2001. There was a remarkable increase over time in the proportion of male abstainers (36.7% in 2001 and 64.3% in 2014). CONCLUSION: This study highlights important inter- and intra-gender differences in the characteristics and etiological factors of patients with CLD in Italy.
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