Bridging the gap: Time to integrate sex and gender differences into research and clinical practice for improved health outcomes

European Journal of Internal Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

The integration of sex and gender in medical research clinical practice is increasingly recognized as a cornerstone for achieving equitable health outcomes. Biological influence the manifestation, progression, treatment response numerous diseases. influences disease outcomes through genetic, hormonal, physiological factors, while impacts them via identity, societal roles behaviors. Historically, has focused predominantly on male body, leading to diagnostic therapeutic gaps women gender-diverse populations. In particular, remain underrepresented trials, suboptimal strategies addition, many conditions, such cardiovascular, metabolic neurological diseases, sex-specific variations risk factors presentation are prominent. present review discusses critical importance distinguishing between preclinical research, necessity incorporating these variables across all stages from study design analysis reporting studies trials. By distinct but interacting variables, we propose framework advance equity foster personalized, inclusive healthcare. This approach will promote development gender-sensitive guidelines, enhance accuracy tools, ultimately contribute improved individuals, regardless their or identity.

Language: Английский

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Effect of Supplementation of a Butyrate-Based Formula in Individuals with Liver Steatosis and Metabolic Syndrome: A Randomized Double-Blind Placebo-Controlled Clinical Trial

Nutrients, Journal Year: 2024, Volume and Issue: 16(15), P. 2454 - 2454

Published: July 28, 2024

Postbiotics could exert different metabolic activities in animal models of non-alcoholic fatty liver disease (NAFLD) and humans affected by syndrome. This is a randomized, double-blind, placebo-controlled, parallel-group clinical trial that enrolled sample 50 Caucasian healthy individuals with NAFLD, defined as steatosis, After 4-week run-in, the were randomized to take food for special medical purposes functional release, one tablet day, containing calcium butyrate (500 mg/tablet), zinc gluconate (zinc 5 vitamin D3 IU/tablet), or an identical placebo 3 months. Liver parameters measured at baseline end study. No subject experienced any adverse events during trial. In both groups, significant decrease total cholesterol (TC) triglycerides (TG) plasma levels was observed randomization visit vs. pre-run-in (

Language: Английский

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Metabolic dysfunction-associated steatotic liver disease: A sexually dimorphic disease and breast and gynecological cancer

Metabolism, Journal Year: 2025, Volume and Issue: unknown, P. 156190 - 156190

Published: March 1, 2025

Language: Английский

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Risk of Serious Bacterial and Non‐Bacterial Infections in People With MASLD

Liver International, Journal Year: 2025, Volume and Issue: 45(4)

Published: March 12, 2025

ABSTRACT Metabolic dysfunction‐associated steatotic liver disease (MASLD) has become the most common chronic globally. MASLD is a multisystem where metabolic dysfunction plays key role in development of and its relevant liver‐related morbidities extrahepatic complications, such as cardiovascular disease, kidney certain types cancers. Among least examined MASLD‐related an ever‐increasing number observational studies have reported positive association between risk serious bacterial infections (SBI) requiring hospital admission. This remained significant those statistical analysis was adjusted for age, sex, ethnicity, obesity, type 2 diabetes other comorbidities. Notably, incidence rates SBI were further increased with more advanced MASLD, especially patients cirrhosis, also observed some acute viral infections, including SARS‐CoV‐2 infection, leading to severe COVID‐19. In this narrative review article, we provide overview literature on (a) recent epidemiological data linking non‐bacterial admission, (b) putative underlying mechanisms through which may increase susceptibility both directly immune associated cirrhosis portal hypertension, (c) practical clinical implications growing global population MASLD.

Language: Английский

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MASLD: Prevalence, Mechanisms, and Sex-Based Therapies in Postmenopausal Women

Biomedicines, Journal Year: 2025, Volume and Issue: 13(4), P. 855 - 855

Published: April 2, 2025

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic influenced by genetic, lifestyle, and environmental factors. While MASLD more prevalent in men, women are at increased risk after menopause, highlighting critical pathogenetic role of sex hormones. The complex interplay between estrogen deficiency, visceral fat accumulation, metabolic syndrome (MetS), inflammation accelerates progression, increases cardiovascular (CV) risk, triggers a cycle worsening adiposity, dysfunction, psychological problems, including eating disorders. Weight loss postmenopausal can significantly improve both outcomes, helping to prevent related conditions. This review examines prevalence MASLD, its comorbidities (type 2 diabetes T2D, CV, mental disorders), mechanisms, pharmacological treatment with GLP-1 receptor agonists (GLP1-RAs), focus on women. Given use GLP1-RAs obesity T2D patients, increase MetS this analyzes potential stable GLP-1–estrogen conjugate as therapeutic approach subgroup. By combining synergistic effects hormones, dual agonist has been shown food intake reward suppression, resulting greater weight improved insulin sensitivity, glucose, lipid metabolism. Therefore, we hypothesize that pharmacotherapy may provide targeted benefits than either hormone alone protecting liver, β-cells, overall health. As these only supported preclinical data, highlights need for future research evaluate confirm mechanisms efficacy clinical settings, particularly

Language: Английский

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Hepatic immune regulation and sex disparities

Nature Reviews Gastroenterology & Hepatology, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 5, 2024

Language: Английский

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Sex‐specific effects of PNPLA3 I148M

Liver International, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 11, 2024

Abstract Metabolic dysfunction–associated steatotic liver disease (MASLD, previously termed NAFLD, nonalcoholic fatty disease) is a complex multifactorial showing generally higher prevalence and severity in men than women. With respect to women, are also more prone develop metabolic steatohepatitis, fibrosis liver‐related complications. Several genetic, hormonal, environmental lifestyle factors may contribute sex differences MASLD development, progression outcomes. However, after menopause, the sex‐specific of shows an opposite trend between pointing relevance oestrogen signalling sexual dimorphism MASLD. The patatin‐like phospholipase domain‐containing protein 3 ( PNPLA3 ) gene, that encodes triacylglycerol lipase plays crucial role lipid metabolism, has emerged as key player pathogenesis MASLD, with I148M variant being strongly associated increased fat content severity. Recent advances indicate carrying can be risk factor for especially To elucidate molecular mechanisms underlying development several vitro, ex vivo models have been developed.

Language: Английский

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Sex differences in the relationship between body composition and MASLD progression in a murine model of metabolic syndrome

iScience, Journal Year: 2025, Volume and Issue: 28(2), P. 111863 - 111863

Published: Jan. 21, 2025

Language: Английский

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The development of a food-group, tree classification method and its use in exploring dietary associations with Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD) and other health-related outcomes in a UK Population

Metabolism Open, Journal Year: 2025, Volume and Issue: unknown, P. 100351 - 100351

Published: Jan. 1, 2025

Language: Английский

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Updated recommendations for the management of metabolic dysfunction–associated steatotic liver disease (MASLD) by the Latin American working group.

Annals of Hepatology, Journal Year: 2025, Volume and Issue: unknown, P. 101903 - 101903

Published: March 1, 2025

Metabolic dysfunction-associated steatotic liver disease (MASLD) is one of the leading causes chronic globally. Based on 2023 definition, MASLD characterized by presence metabolic dysfunction and limited alcohol consumption (<140 grams/week for women, <210 men). Given significant burden in Latin America, this guidance was developed American Association Study Liver (ALEH) Working Group to address key aspects its clinical assessment therapeutic strategies. In ultrasonography recommended as initial screening tool hepatic steatosis due accessibility, while Fibrosis-4 (FIB-4) preferred fibrosis risk stratification, with further evaluation using more specific techniques (i.e., vibration-controlled transient elastography or Enhanced Fibrosis [ELF] test). A Mediterranean diet advised all patients, a target 7-10% weight loss those excess weight. Complete abstinence patients fibrosis, smoking cessation encouraged regardless stage. Pharmacological options should be tailored based steatohepatitis, weight, diabetes, including resmetirom, incretin-based therapies, pioglitazone, sodium-glucose cotransporter-2 inhibitors. Bariatric surgery may considered obesity unresponsive lifestyle medical interventions. Hepatocellular carcinoma cirrhotic consideration given advanced individual risk. Finally, routine cardiovascular proper diabetes prevention management remain crucial MASLD.

Language: Английский

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