Non-alcoholic fatty liver disease in women - Current knowledge and emerging concepts

Pei Chia Eng; Roberta Forlano; Tricia Tan; Pinelopi Manousou; Waljit S Dhillo; Chioma Izzi-Engbeaya

doi:10.1016/j.jhepr.2023.100835

Non-alcoholic fatty liver disease in women - Current knowledge and emerging concepts

JHEP Rep. 2023 Jun 29;5(10):100835. doi: 10.1016/j.jhepr.2023.100835. eCollection 2023 Oct.

Authors

Pei Chia Eng^{1

2}, Roberta Forlano^{1

3}, Tricia Tan^{1

2}, Pinelopi Manousou^{1

3}, Waljit S Dhillo^{1

2}, Chioma Izzi-Engbeaya^{1

2}

Affiliations

¹ Department of Metabolism, Digestion and Reproduction, Imperial College London, UK.
² Department of Diabetes and Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
³ Department of Hepatology, Imperial College Healthcare NHS Trust, London, UK.

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a major cause of liver disease worldwide, affecting up to 30% of adults. Progression to non-alcoholic steatohepatitis (NASH) is a key risk factor for cirrhosis, hepatocellular carcinoma and cardiovascular events. Alterations in reproductive hormones are linked to the development and/or progression of NAFLD/NASH in women. Women with polycystic ovary syndrome and those with oestrogen deficiency are at increased risk of NAFLD/NASH, with higher mortality rates in older women compared to men of similar ages. NAFLD/NASH is currently the leading indication for liver transplantation in women without hepatocellular carcinoma. Therefore, a better understanding of NAFLD in women is needed to improve outcomes. In this review, we discuss the hormonal and non-hormonal factors that contribute to NAFLD development and progression in women. Furthermore, we highlight areas of focus for clinical practice and for future research.

Keywords: Androgens; Estrogens; Menopause; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Women.

Publication types

Review