Sexual Dimorphisms in Nonalcoholic Fatty Liver Disease

Abstract

This review focuses on how sex differences play a role in the development and progression of NAFLD, describe inconsistencies in current findings, and propose goals for future studies. NAFLD prevalence and severity is higher in men than in premenopausal women. After menopause, prevalence of NAFLD increases, suggesting a protective effect of estrogen. Androgen excess may also increase the risk of steatosis in women. Furthermore, there is a strong interplay between hormonal changes and development of visceral adiposity and metabolic syndrome, both closely related to NAFLD progression. Despite advancements in research, our understanding of sexual dimorphism in NAFLD remains incomplete. While results are varied, it is apparent that sex differences with regard to endogenous hormones, reproductive stage, metabolic risk factors, and body fat distribution all play a significant role in the development of NAFLD. Future studies should aim to develop sex-specific therapies to mitigate the rising prevalence of NAFLD.