P0987 - Gender Disparities in Extrahepatic Manifestations Among NAFLD Patients

Khaled Alsabbagh Alchirazi, MD¹, Alia Khamis, MD², Thabet Qapaja, MD¹, Nour Azzouz, MD¹, Talal Sarmini, MD¹, Jamile Wakim-Fleming, MD^1
1Cleveland Clinic, Cleveland, OH; ²University of Rochester Medical Center, Rochester, NY

Introduction: Non-alcoholic fatty liver disease (NAFLD (has been an emerging concern in recent years due to increasing incidence which reached 25% of the general population. Although recent publications shed light on gender differences in this patient population, we still face many limitations in elucidating them. NALFD can cause significant morbidity as it progresses to nonalcoholic steatohepatitis (NASH), which increases the risk of cirrhosis and liver failure. Gaining a deeper understanding of these disparities will aid in developing targeted prevention strategies and personalized therapeutic interventions for NAFLD. In this study, we aim to elucidate extrahepatic differences between males and females who were diagnosed with NAFLD.

Methods: We conducted a retrospective cohort study using the TrinNetX, a multi-institutional database. The study included all adult patients aged 18 years or older diagnosed with NAFLD using ICD-10 codes. The study population was divided into two groups based on gender. Data on extrahepatic manifestations were gathered. We excluded patients with alcoholic liver disease, drug induced liver injury, autoimmune hepatitis, viral hepatitis, and cirrhosis. We employed 1:1 propensity score matching for age, race, tobacco use, obesity, diabetes, and alcohol abuse.

Results: Before matching, we identified 526,493 females and 425,799 males with NAFLD. After appropriate matching, 402,454 patients were included in each arm. The presence of the following was lower in females when compared with male patients with NAFLD: chronic kidney disease (CKD) (OR 0.71), obstructive sleep apnea (OSA) (OR 0.68), Esophageal cancer (OR 0.24), Gastric cancer (OR 0.52), Colon cancer (OR 0.79), HCC (OR 0.74), Myocardial infarction (MI) (OR 0.60), and Heart failure (HF) (OR 0.71). Contrarily, the following were found to be more prevalent in female patients with NAFLD when compared with males: COPD (OR 1.04), general anxiety disorder (GAD) (OR 1.92), Depression (OR 1.95), Hypothyroidism (OR 2.86), Osteoporosis (OR 5.16) and Sarcopenia (OR 1.13). No significant gender differences were noted in psoriasis and pancreatic cancer among patients with NAFLD.

Discussion: Patients with NAFLD show significant difference in prevalence of extrahepatic manifestations with regards to gender. Clinicians must be aware of the gender disparities among NAFLD patients and appropriate screening should be applied. Future studies are needed to understand the mechanisms underlying these differences.




Disclosures:


Khaled Alsabbagh Alchirazi, MD¹, Alia Khamis, MD², Thabet Qapaja, MD¹, Nour Azzouz, MD¹, Talal Sarmini, MD¹, Jamile Wakim-Fleming, MD¹. P0987 - Gender Disparities in Extrahepatic Manifestations Among NAFLD Patients, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.