Department of Surgery, Oncology, and Gastroenterology, Gastroenterology and Multivisceral Transplant Unit, Padua University Hospital, Padua, Italy.
Hepatology and Gastroenterology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
United European Gastroenterol J. 2023 Mar;11(2):218-227. doi: 10.1002/ueg2.12370. Epub 2023 Mar 3.
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.
酒精相关肝病（ArLD）是全球慢性肝病的主要病因。传统上，ArLD 主要发生在男性而不是女性中；然而，由于女性慢性酒精消费的增加，这种性别差距正在迅速缩小。女性对酒精的有害影响更为敏感，其肝硬化进展和相关并发症的风险更高。女性肝硬化和与肝脏相关的死亡率的相对风险明显高于男性。我们的综述旨在总结目前关于酒精代谢、ArLD 发病机制、疾病进展、肝移植指征和 ArLD 药物治疗方面的性别差异的知识，并提供支持这些患者进行性别特异性管理的证据。
