ReviewHepatology (Baltimore, Md.)2019
Sex Differences in Nonalcoholic Fatty Liver Disease: State of the Art and Identification of Research Gaps.
Review in Hepatology (Baltimore, Md.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 571 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
571 citing papers in PubMed, 7 syntheses or guidelines pooled it, 1,020 citations in OpenAlex.
- Clinical Practice Guidelines for Adult MASLD in Bosnia and Herzegovina: National Recommendations for Diagnosis, Risk Stratification, and Treatment.Acta medica academica · 2026Guideline
- Global and regional prevalence, burden, and risk factors for MASLD in children and adolescents aged 5 to 24 years: a systematic review, meta-analysis, and modeling study.BMC medicine · 2026Pooled it
- The impact of long-term exercise on liver function, fatty liver progression, and related metabolic markers in NAFLD patients: a meta-analysis of randomized controlled trials.Frontiers in nutrition · 2026Pooled it
- Total ultra-processed food intake and selected food-group exposures in relation to non-alcoholic fatty liver disease: a systematic review and meta-analysis.Frontiers in nutrition · 2026Pooled it
- Glucagon-Like Peptide-1 Receptor Agonists Improve MASH and Liver Fibrosis: A Meta-Analysis of Randomised Controlled Trials.Liver international : official journal of the International Association for the Study of the Liver · 2025Pooled it
- An updated systematic review and meta-analysis: correlation between circulating plasminogen activator inhibitor-1 levels and metabolic dysfunction-associated steatotic liver disease.BMC gastroenterology · 2025Pooled it
- Pooled it
- A carotenoid-rich functional tomato sauce (OsteoCol®) reduces liver fat content in adults with metabolic dysfunction-associated steatotic liver disease: a randomized clinical trial.European journal of nutrition · 2026Trial
- Systematic Comparison of High-Fat Diet- and Streptozotocin-Induced Prediabetic Obese C57BL/6J Mouse Models: A Sex-Based Protocol Optimization Study.Diabetes, obesity & metabolism · 2026Article
- Exploring the Association Between Colorectal Cancer Metastasis and Metabolic Dysfunction-Associated Steatotic Liver Disease: A Nationwide Analysis.World journal of oncology · 2026Article
- MASLD in type 2 diabetes: steatosis-fibrosis burden and metabolic determinants in a real-world cohort.Acta diabetologica · 2026Article
- Metabolic Dysfunction-Associated Steatotic Liver Disease in the Aging Population: A Narrative Review of Pathophysiological Synergy, Diagnostic Challenges, and Tailored Management.Current gastroenterology reports · 2026Review
- Sexual dimorphism in the association of circulating TAM receptors-ligands with MASLD-related fibrosis.JHEP reports : innovation in hepatology · 2026Observational
- Time-Varying Impact of Steatosis and Alcohol on Mortality: A Marginal Structural Model of the Canadian Longitudinal Study on Aging.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Temporal changes in sex and race/ethnicity incidence rate ratios for hepatocellular carcinoma in the United States, 1992-2022.Cancer causes & control : CCC · 2026Article
- Schisandrin B Targets the PPARγ-MAPK Signaling Axis to Ameliorate High-Fat MCD Diet-Induced MASLD in Mice.Pharmaceuticals (Basel, Switzerland) · 2026Article
- [Across-sectional study on the association between steatotic liver disease and its subtypes, cardiovascular health status, and extrahepatic comorbidity].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Article
- Odds for Presence of Metabolic Dysfunction Associated Steatotic Liver Disease ( MASLD) in Individuals with Reported Hepatic Steatosis on Ultrasound.Pakistan journal of medical sciences · 2026Article
- Development and validation of a risk model for non-fatty chronic liver disease in middle-aged and older adults with metabolic syndrome.BMC gastroenterology · 2026Article
- Sex- and menopause-specific inverse associations between metabolic dysfunction-associated steatotic liver disease and serum lipoprotein(a) concentrations: evidence from SHIP and UK Biobank.Cardiovascular diabetology · 2026Article
511 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 6 institutions in 2 countries.
Funding
Abstract
Despite tremendous research advancements in nonalcoholic fatty liver disease (NAFLD), our understanding of sex differences in NAFLD remains insufficient. This review summarizes the current knowledge on sex differences in NAFLD, identifies gaps, and discusses important considerations for future research. The prevalence and severity of NAFLD are higher in men than in women during the reproductive age. However, after menopause, NAFLD occurs at a higher rate in women, suggesting that estrogen is protective. Sex differences also exist for the major risk factors of NAFLD. In general, animal models of NAFLD recapitulate the sex differences observed in patients, with more severe steatosis and steatohepatitis, more proinflammatory/profibrotic cytokines, and a higher incidence of hepatic tumors in male than female subjects. Based on computer modeling, female and male livers are metabolically distinct with unique regulators modulating sex-specific metabolic outcomes. Analysis of the literature reveals that most published clinical and epidemiological studies fail to examine sex differences appropriately. Considering the paucity of data on sex differences and the knowledge that regulators of pathways relevant to current therapeutic targets for NAFLD differ by sex, clinical trials should be designed to test drug efficacy and safety according to sex, age, reproductive stage (i.e., menopause), and synthetic hormone use. Conclusion: Sex differences do exist in the prevalence, risk factors, fibrosis, and clinical outcomes of NAFLD, suggesting that, while not yet incorporated, sex will probably be considered in future practice guidelines; adequate consideration of sex differences, sex hormones/menopausal status, age, and other reproductive information in clinical investigation and gene association studies of NAFLD are needed to fill current gaps and implement precision medicine for patients with NAFLD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.