Sex-related differences in the prevalence, clinical characteristics, and comorbidities of metabolic dysfunction-associated steatotic liver disease

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common chronic liver disease in patients with fatty liver and cardiometabolic risk factors. Its prevalence and severity are higher in men than in women of reproductive age; however, the prevalence increases in women after menopause. MASLD patients are at higher risk of cardiovascular death than of liver-related mortality. Aim: This study aimed to assess sex-related differences in the prevalence and clinical characteristics of patients with MASLD, with particular attention to comorbidities. Material and methods: The study included 887 patients (461 women [52.0%]; 426 men [48.0%]). Demographic data, lifestyle factors, medical history, anthropometric measurements, blood pressure values, and laboratory test results were collected. Results and discussion: The median age of patients was 70 years (range, 18–96 years). The mean BMI (body mass index) of the study patients was elevated, with no significant differences between women and men. Significant associations were noted between sex and several comorbidities. However, effect size measures indicated that these associations were weak or very weak. Cardiovascular risk was assessed as very high in 73.5% of participants and as high in 17.4%, with no significant differences between sexes. Despite the predominantly very high or high cardiovascular risk, the lipid profiles of the study patients were suboptimal. Conclusions: Patients with MASLD exhibited a high burden of metabolic and cardiovascular comorbidities, irrespective of sex, highlighting the need for individualized preventive and therapeutic strategies.