FEMALE SEX AND THE RISK OF LIVER-CIRRHOSIS

Background: Evidence on gender-related differences in susceptibility t o alcohol-induced liver diseases is questionable with regard to both m ethodologic and clinical aspects. With the aim to assess the role of g ender in the risk of liver cirrhosis, independently and in combination with known risk factors, data from three case-control studies perform ed in various Italian areas were analysed. Methods: The cases were 462 cirrhotic patients (300 men and 162 women) admitted for the first tim e to hospital for liver decompensation. Controls were 651 patients (35 5 men and 296 women) admitted to the same hospitals during the same pe riod as the cases, for acute diseases unrelated to alcohol. Alcohol co nsumption was expressed as lifetime daily alcohol intake. Results: A s ignificant and independent associations between alcohol intake, chroni c hepatitis B and C virus infections, and the risk of liver cirrhosis was observed. The effect of alcohol intake was multiplicatively increa sed in women. The odds ratio (OR) increased from 1.0 (reference catego ry: men, lifetime abstainers) to 31.4 (95% confidence interval (CI), 1 0.3-95.8) 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 li ver cirrhosis associated with female gender independently of alcohol c onsumption and virus infection was also observed. Conclusions: A highe r susceptibility to alcohol-induced liver diseases was confirmed for w omen, and an independent effect of female sex on the risk of cirrhosis was observed. Besides alcohol and viruses, some unknown gender-relate d factor might then be involved in the occurrence of the disease.