title: The prevalence of nonalcoholic steatohepatitis is greater in morbidly obese men compared to women.
abstract: BACKGROUND
  Nonalcoholic steatohepatitis (NASH) is a form of liver injury that is common in morbidly obese subjects. It has been shown that gender differences exist in the spectrum of nonalcoholic fatty liver disease (NAFLD). The focus of this study was to further characterize these gender differences based on ATP III criteria used to diagnose the metabolic syndrome (MS).
  
  
  METHODS
  We retrospectively assessed NAFLD 58 men and 307 women who underwent gastric bypass, for the presence of NASH, MS, and positive predictors of NASH.
  
  
  RESULTS
  There was no statistical difference in age, gender, or the presence of diabetes. The prevalence of NASH in men and women was 60.3% and 30.9%, respectively (P<0.001). Multivariate logistic analysis showed an association of male gender with NASH (2.7; 95% CI, 1.3-5.6, P=0.006) as well as age, AST, and diabetes. MS was diagnosed in 91.4% and 76.2% of men and women (P=0.008), and men tended to have more criteria for MS compared to women. The only positive predictor of MS that was statistically significant between genders was high triglycerides (P=0.003). Controlling for BMI and excess body weight produced similar results.
  
  
  CONCLUSIONS
  Gender differences do exist within NAFLD and MS, that may be associated with free fatty acid flow to the liver.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, University of Alabama, Birmingham, AL 35294, USA.
authors.forename: Janani
authors.initials: J
authors.lastname: Arun
authors.forename: Ronald H
authors.initials: RH
authors.lastname: Clements
authors.forename: Audrey J
authors.initials: AJ
authors.lastname: Lazenby
authors.forename: Ruth R
authors.initials: RR
authors.lastname: Leeth
authors.forename: Gary A
authors.initials: GA
authors.lastname: Abrams
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005234:Fatty Liver / Q000453:epidemiology*; D005260:Female; D006505:Hepatitis / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors