Corrao G, Aricò S, Zambon A, Torchio P, Di Orio F
Institute of Statistical and Mathematical Sciences, University of Milan, Italy.
Scand J Gastroenterol. 1997 Nov;32(11):1174-80. doi: 10.3109/00365529709002999.
Evidence on gender-related differences in susceptibility to alcohol-induced liver diseases is questionable with regard to both methodologic and clinical aspects. With the aim to assess the role of gender in the risk of liver cirrhosis, independently and in combination with known risk factors, data from three case-control studies performed in various Italian areas were analysed.
The cases were 462 cirrhotic patients (300 men and 162 women) admitted for the first time to hospital for liver decompensation. Controls were 651 patients (355 men and 296 women) admitted to the same hospitals during the same period as the cases, for acute diseases unrelated to alcohol. Alcohol consumption was expressed as lifetime daily alcohol intake.
A significant and independent associations between alcohol intake, chronic hepatitis B and C virus infections, and the risk of liver cirrhosis was observed. The effect of alcohol intake was multiplicatively increased in women. The odds ratio (OR) increased from 1.0 (reference category: men, lifetime abstainers) to 31.4 (95% confidence interval (CI), 10.3-95.8) in men drinking more than 100 g/day of alcohol, and from 2.2 (95% CI, 1.0-7.1) in abstaining women to 44.8 (95% CI, 8.2-224.0) in women drinking more than 100 g/day of alcohol. An increased risk of liver cirrhosis associated with female gender independently of alcohol consumption and virus infection was also observed.
A higher susceptibility to alcohol-induced liver diseases was confirmed for women, and an independent effect of female sex on the risk of cirrhosis was observed. Besides alcohol and viruses, some unknown gender-related factor might then be involved in the occurrence of the disease.
关于酒精性肝病易感性的性别差异，在方法学和临床方面的证据都存在疑问。为了评估性别在肝硬化风险中的作用，独立地以及与已知风险因素相结合进行评估，对在意大利不同地区开展的三项病例对照研究的数据进行了分析。
病例为462例首次因肝失代偿入院的肝硬化患者（300例男性和162例女性）。对照为651例患者（355例男性和296例女性），他们在与病例相同的时期因与酒精无关的急性疾病入住同一医院。酒精摄入量以终生每日酒精摄入量表示。
观察到酒精摄入量、慢性乙型和丙型肝炎病毒感染与肝硬化风险之间存在显著且独立的关联。女性中酒精摄入量的影响呈相乘增加。男性每天饮酒超过100克时，比值比（OR）从1.0（参考类别：男性，终生戒酒者）增至31.4（95%置信区间（CI），10.3 - 95.8），而女性中，从不饮酒者的OR为2.2（95%CI，1.0 - 7.1），每天饮酒超过100克的女性OR为44.8（95%CI，8.2 - 224.0）。还观察到与女性性别相关的肝硬化风险增加，且独立于酒精消费和病毒感染。
证实女性对酒精性肝病的易感性更高，且观察到女性性别对肝硬化风险有独立影响。除了酒精和病毒外，一些未知的性别相关因素可能也参与了该疾病的发生。
