Abstract
Background. Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease. A large number of studies have strongly described larger proportions of men being afflicted with NAFLD than women; however, recent studies investigating the role of gender and NAFLD have exposed the contrary. Methods. This cross-sectional study utilized data from the baseline survey of an ongoing cohort study called the Cholangiocarcinoma Screening and Care Program (CASCAP), conducted in the northeastern region of Thailand between March 2013 and September 2015. Information regarding socio-demographic, including gender, was collected using a standardized self-administered questionnaire. NAFLD was diagnosed with ultrasonography by board-certified radiologists. A binomial regression was used for estimating the prevalence differences, odds ratios (OR) and the 95% confidence intervals (CI) of NAFLD between men and women. Results. A total of 34,709 participants (27,073 females and 7,636 males) were recruited. The prevalence of NAFLD in women was 22.9% (95% CI: 22.5 to 23.5), whereas it was only 18.3% (95% CI: 17.4 to 19.2) in men. After adjusting for age and presence of diabetes mellitus and other underlying diseases, the prevalence was significantly higher in women, with adjusted prevalence difference of 4.2% (95% CI: 3.2 to 5.2) and adjusted OR of 1.3 (95% CI: 1.2 to 1.4). Women had a higher prevalence of NAFLD than men in all age groups and the largest difference was found in those aged 56-60 years (prevalence = 27.4% versus 21.2%; adjusted prevalence difference = 9.4%; 95% CI: 7.9 to 10.9; adjusted OR = 1.8; 95% CI: 1.8 to 2.0). Conclusion. NAFLD is more likely to affect women more than men, in particular, among the population 56-60 years of age, which is the post-menopausal transitional period. Therefore, post-menopausal women should be the target for interventions or further investigation for NAFLD.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease and a major public health problem worldwide1
NAFLD is closely associated with type 2 diabetes mellitus (T2DM), and T2DM is used as a determinant for the presence and severity of NAFLD12,13
Our study found that an increased prevalence of NAFLD in female participants persisted in the post-menopausal group, while the prevalence trend declined in those aged more than 65 years compared with premenopausal women
Summary
Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease and a major public health problem worldwide. NASH patients run an increased risk of cardiovascular mortality as a result of the metabolic risk factors that are common to both NAFLD and cardiovascular disease. Various studies have demonstrated that NAFLD is more prevalent in men, elderly populations, and post-menopausal women. A binomial regression was used for estimating the prevalence differences, odds ratios (OR) and the 95% confidence intervals (CI) of NAFLD between men and women. The prevalence of NAFLD in women was 22.9% (95% CI: 22.5 to 23.5), whereas it was only 18.3% (95% CI: 17.4 to 19.2) in men. Women had a higher prevalence of NAFLD than men in all age groups and the largest version 2
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