Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in Italian women: is liver fibrosis independent from menopause?

IF 4 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease Pub Date : 2025-02-01 DOI:10.1016/j.dld.2025.01.103

R. Chen , A. Salamone , C. Abbati , R. Capelli , E. Santangeli , B. Stefanini , M.G. Indre , F. Ravaioli , F. Piscaglia , S. Ferri

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Abstract

Background and Aims

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is an emerging health concern among women, with menopause influencing its onset and progression. This study aimed to explore the connection between menopause and liver fibrosis in MASLD.

Method

Between October 2014 and September 2024, 149 non-cirrhotic women were enrolled and underwent comprehensive evaluations, including physical activity and diet quality assessments (IPAQ and REAP-S scores). Significant liver fibrosis was defined as liver stiffness ≥ 7 kPa on 2D-elastography. Cardiovascular risk was assessed with ESC scores, and insulin resistance with TyG index.

Results

Of 149 women, 41 were pre-menopausal (median age 46, 17.1% fibrotic) and 108 post-menopausal (median age 61, 27.8% fibrotic). Fibrotic women were older (median age 64 vs. 56, p < 0.001) and had higher rates of hypertension (64.9% vs. 43.8%, p = 0.026), type 2 diabetes (T2DM 40.5% vs. 16.1%, p = 0.002), and insulin resistance (TyG index: 4.9 vs. 4.7, p = 0.024). BMI, menopause status, age at menopause were similar between fibrotic and non-fibrotic women. Multivariate analysis revealed that age (OR 1.068, p = 0.002) and T2DM (OR 3.633, p = 0.004) were independently associated with fibrosis. Compared to non-fibrotic, fibrotic post-menopausal women had poorer diet quality (REAPS score: 26 vs. 31, p = 0.018), higher rates of hypertension (73.3% vs. 46.2%, p = 0.011) and T2DM (40% vs. 17.9%, p = 0.016), and a higher risk of CV events (11.1% vs. 6.1%, p < 0.001). Multivariate analysis confirmed that hypertension (OR 2.959, p = 0.024) and T2DM (OR 2.752, p = 0.039) were independently associated with fibrosis in post-menopausal women.

Conclusion

T2DM drives liver fibrosis in both pre- and post-menopausal women, while hypertension is linked to fibrosis only in post-menopausal women, with diet quality posing additional challenges, particularly for post-menopausal women, possibly due to socioeconomic factors.

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来源期刊

Digestive and Liver Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

2.20%

发文量

632

审稿时长

19 days

期刊介绍： Digestive and Liver Disease is an international journal of Gastroenterology and Hepatology. It is the official journal of Italian Association for the Study of the Liver (AISF); Italian Association for the Study of the Pancreas (AISP); Italian Association for Digestive Endoscopy (SIED); Italian Association for Hospital Gastroenterologists and Digestive Endoscopists (AIGO); Italian Society of Gastroenterology (SIGE); Italian Society of Pediatric Gastroenterology and Hepatology (SIGENP) and Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD). Digestive and Liver Disease publishes papers on basic and clinical research in the field of gastroenterology and hepatology. Contributions consist of: Original Papers Correspondence to the Editor Editorials, Reviews and Special Articles Progress Reports Image of the Month Congress Proceedings Symposia and Mini-symposia.