Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
Department of Tropical and Infectious Diseases, Policlinico Umberto Primo, Rome, Italy.
Infection. 2018 Feb;46(1):93-101. doi: 10.1007/s15010-017-1101-5. Epub 2017 Nov 17.
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).
The two surveys prospectively recruited patients aged ≥ 18 referring to Italian liver units throughout the country using a similar clinical approach and analytical methods.
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).
This study highlights important inter- and intra-gender differences in the characteristics and etiological factors of patients with CLD in Italy.
慢性肝病（CLD）中的性别差异已部分得到研究。为了扩展现有知识，我们评估了在两项全国性调查中招募的 12263 名 CLD 患者（2001 年 9997 名和 2014 年 2557 名）。
这两项调查使用类似的临床方法和分析方法，前瞻性地招募了全国各地意大利肝脏单位的年龄≥18 岁的患者。
总体男性与女性的比例（M/F）为 1.4（7138/5124）。与女性相比，男性更年轻（52.9 岁 vs. 58.7 岁），单纯乙型肝炎病毒感染（13.2% vs. 9.2%）和单纯酒精性肝病（11.4% vs. 6.9%）更为常见，但单纯丙型肝炎病毒感染（48.0% vs. 67.9%）较少见。乙型肝炎病毒相关病例（1.99）和酒精相关病例（2.3）中存在男性优势，这种优势在 2001 年和 2014 年的病例中均有观察到。然而，在丙型肝炎病毒相关病例中，2001 年女性居多（M/F 0.9），2014 年男性居多（M/F 1.5）。在酒精性病因中，肝硬化的发生率在两性中接近 36%，这一发现明显高于乙型肝炎病毒和丙型肝炎病毒病因中两性的肝硬化发生率。2014 年纳入的男性和女性均较 2001 年更年长（p<0.001），且肝硬化和/或 HCC 的发生率更高（p<0.001）。男性和女性中戒酒者的比例随着时间的推移显著增加（2001 年为 36.7%，2014 年为 64.3%）。
本研究突出了意大利 CLD 患者特征和病因因素中的重要性别间和性别内差异。
