Non-alcoholic fatty liver disease in women – Current knowledge and emerging conceptsKey points
Pei Chia Eng,
Roberta Forlano,
Tricia Tan,
Pinelopi Manousou,
Waljit S. Dhillo,
Chioma Izzi-Engbeaya
Affiliations
Pei Chia Eng
Department of Metabolism, Digestion and Reproduction, Imperial College London, UK; Department of Diabetes and Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Roberta Forlano
Department of Metabolism, Digestion and Reproduction, Imperial College London, UK; Department of Hepatology, Imperial College Healthcare NHS Trust, London, UK
Tricia Tan
Department of Metabolism, Digestion and Reproduction, Imperial College London, UK; Department of Diabetes and Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Pinelopi Manousou
Department of Metabolism, Digestion and Reproduction, Imperial College London, UK; Department of Hepatology, Imperial College Healthcare NHS Trust, London, UK
Waljit S. Dhillo
Department of Metabolism, Digestion and Reproduction, Imperial College London, UK; Department of Diabetes and Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Chioma Izzi-Engbeaya
Department of Metabolism, Digestion and Reproduction, Imperial College London, UK; Department of Diabetes and Endocrinology, Imperial College Healthcare NHS Trust, London, UK; Corresponding author. Address: Section of Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, Du Cane Road, London, W12 0NN, UK.
Summary: 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.
